Computer-assisted instruction.

R. A. Seltzer's (see record 1972-11839-001) statement that suggests an inhibition of social skill development in 1st graders subjected to computer-assisted instruction lacks supporting evidence. The study's results were confounded by its limitation to one school, teacher effects, raters' knowledge of conditions, and the social behavior measurement instrument. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

MR imaging of the knee ligaments and the postoperative knee

MR imaging is an accurate, noninvasive, and cost-effective method for the evaluation of acute knee ligament injuries and in the examination of the postoperative knee. Understanding the normal anatomy and the pertinent clinical aspects of knee injuries is a prerequisite for accurate interpretation of MR imaging studies. The increasing popularity of ACL reconstruction following disruption of this ligament requires knowledge of the various surgical techniques and their MR imaging appearance as well as the appearance of possible complications.     

Meniscal position on routine MR imaging of the knee

OBJECTIVE: To determine the prevalence of meniscal protrusion (i.e. location of the outer edge of a meniscus beyond the tibial articular surface), and to determine its relationship with internal derangement, joint effusion, and degenerative arthropathy. DESIGN AND PATIENTS: Sagittal and coronal MR images of 111 abnormal and 46 normal knees were evaluated for the presence of meniscal protrusion. We set 25% as the minimum amount of displacement considered abnormal because this was the smallest amount of displacement we could confidently discern. Presence of meniscal tear, anterior cruciate ligament (ACL) injury, joint effusion, or osteophytosis was also recorded. RESULTS AND CONCLUSION: Normal examinations demonstrated protrusion of the medial meniscus in 6.5% of sagittal images and 15% of coronal images, and of the lateral meniscus in 2% and 13%, respectively. Fisher's exact test demonstrated a statistically significant difference between the normal and abnormal groups for the medial meniscus on both sagittal (P < 0.0001) and coronal (P = 0.01) images, but not for the lateral meniscus in either plane (P > 0.2). A protruding medial meniscus was associated with effusion and osteophytosis (P < 0.05) but not with meniscal or ACL tear (P > 0.1). Posterior protrusion of the lateral meniscus was only associated with ACL injury (P < 0.0001); protruding anterior horns and bodies of lateral menisci were not associated with any of the four abnormalities. It is concluded that the medial meniscus may occasionally protrude more than 25% of its width, but protrusion is more often due to effusion and osteophytes. Protrusion of the posterior horn of the lateral meniscus is associated with ACL insufficiency, while protrusion of the body and anterior horn of the lateral meniscus is a normal variant.     

Computer-assisted instruction: What it can and cannot do.

Reviewed current research in computer-assisted instruction to determine which of the 7 paradigms were valid uses of the computer in the instructional process. The 7 modes were drill and practice, tutorial, dialogue, simulation and gaming, retrieval and reorganization of information, problem solving with computational and display tools, and artistic design and composition. Criterion statements are presented to judge the relative merits of each paradigm. Application of these criteria resulted in the tutorial mode, the simulation and gaming mode, the information retrieval and reorganization mode, and the problem solving mode being accepted as valid uses of the computer. Nonvalid uses were the drill and practice mode, the dialogue mode, and as an artist's aid. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internal derangement of the knee after ipsilateral femoral shaft fracture: MR imaging findings

OBJECTIVE: This study uses magnetic resonance (MR) imaging to delineate the types and frequencies of injuries seen in the knee after ipsilateral femoral shaft fracture. We also compare the results of the orthopedic knee examination with the MR findings. DESIGN AND PATIENTS: MR imaging of the ipsilateral knee was performed on 34 patients with closed femoral shaft fractures. Indications for knee MR imaging included knee pain at the time of fracture, soft tissue swelling or an effusion of the knee, or a positive knee examination under anesthesia. The patients had a mean age of 27 years and all were stabilized with intramedullary nails. Imaging was performed a mean time of 2.5 days after surgery. All patients had knee examinations done under anesthesia, and the MR results were compiled and compared with the clinical examinations. RESULTS: Ninety-seven percent of patients demonstrated knee effusions. Twenty-seven percent of patients demonstrated meniscal tears, with the posterior horn of the medial meniscus most frequently torn. The medial collateral ligament was the most frequent site of ligamentous injury (38%) followed by the posterior cruciate ligament (21%). Fifty percent of patients had injuries of the extensor mechanism. Bone bruises were noted in 32% of patients. Articular cartilage injuries were confined to the patella in four cases. One occult tibial plateau fracture and one meniscocapsular separation were seen. CONCLUSIONS: There is a common incidence of both ligamentous and meniscal injury to the knee after ipsilateral femoral shaft fracture. MR imaging can be useful in assessing the extent of injury, and may reveal findings unsuspected after clinical examination of the knee.     

High resolution MR imaging of joint degeneration in the knee of the STR/ORT mouse

MR imaging of the knee joints of the mouse at 2.35 T produces an in-plane resolution of 35 x 70 microns and a slice thickness of 600 microns from the sagittal and coronal planes, in less than 60 min. In normal, live DBA mice, which have no known pathology, the images clearly resolve many joint structures, such as the cruciate ligaments, menisci, and articulating surfaces of the femur and tibia. Gross pathological changes were identified first in excised knees from cadaver mice of the STR/ORT strain. Males of this strain spontaneously exhibit rapid joint degeneration with increasing age compared to females, in which much milder symptoms develop more slowly. Thickening of the patellar tendon, displacement of the patella, deformity, and sclerosis were clearly distinguishable in males compared with females older than 7 mo of age. The same degenerative features were evident in MR images of the knees of the live male but not female STR/ORT mice of this age, indicating that it would be possible to monitor longitudinally by MR imaging progressive development of joint changes in this osteoarthritic model.     

MR imaging

MRI is a tool of unprecedented capabilities for evaluating arthritis and its progression. Not only can it non-invasively delineate the anatomy of all components of a joint with unparalleled clarity, MRI is also capable of probing important functional and compositional parameters of disease in these tissues. Particularly intriguing is MRI's potential for identifying very early changes of joint disease when clinical symptoms may be minimal or absent. Early detection of patients who are at risk for developing progressive disease may allow appropriate treatment to be initiated earlier, when there may be a greater chance of favourable outcome. MRI can, furthermore, provide objective and quantitative measures of disease progression and treatment response. Certain parameters, such as articular cartilage volume, have been validated cross-sectionally; however, their longitudinal performance has yet to be established. Further work is, therefore, necessary to thoroughly validate and optimize some of these measures so that they can begin to be used in more powerful ways to explore the pathophysiology and potential therapies of arthritic disorders.     

Articular cartilage in the knee: mapping of the physiologic parameters at MR imaging with a local gradient coil--preliminary results

The authors designed and constructed a local gradient coil that produces large gradients and short rise times and connects to their clinical system. In a cadaveric patellar cartilage specimen, the coil was used to acquire images of the physiologic parameters T1, T2, proton density, and apparent diffusion coefficient. Variations in these parameters were evident in regions of normal and abnormal cartilage.     

MR imaging of the gallbladder

Implementation of fast T1- and T2-weighted sequences on state-of-the-art magnetic resonance (MR) imagers increases the potential of MR imaging for examining the gallbladder and permits imaging of both cooperative and acutely ill patients with fewer artifacts. Comprehensive evaluation of gallbladder and biliary tract disease is feasible on new generation MR scanners using MR cholangiographic techniques in combination with tissue imaging sequences (spoiled gradient-echo and fat-suppressed spoiled gradient-echo) and dynamic intravenous gadolinium-chelate administration. Inflammatory and neoplastic diseases of the gallbladder are well shown with these techniques.     

MR arthrography of the shoulder: rethinking traditional imaging procedures to meet the technical requirements of MR imaging guidance

Increased serum levels of mucin-associated antigen have been previously demonstrated in patients with cystic fibrosis (CF) and interstitial pneumonia, and in lung-transplant recipients. The present study assessed the serum airway mucin levels in patients with acute respiratory distress syndrome (ARDS). An enzyme-linked immunosorbent assay (ELISA) method with a human-airway-mucin-specific monoclonal antibody (17Q2) was used to measure serum mucin levels in normal subjects, chronic smokers, patients with chronic bronchitis and other pulmonary diseases, patients with acute cardiogenic lung edema, and patients with ARDS. The serum mucin levels measured 9.9 +/- 0.8 ng/ml (mean +/- SEM, n = 59) in normal subjects, 12.7 +/- 1.6 ng/ml (n = 29) in chronic smokers, 21.8 +/- 1.9 ng/ml (n = 28) in patients with chronic bronchitis and other pulmonary diseases, 9.0 +/- 3.1 ng/ml (n = 5) in patients with acute cardiogenic lung edema. The serum mucin level was 53.8 +/- 6.6 ng/ml (n = 13) in patients with ARDS (p < 0.05, as compared with the four other groups). Serial measurements of serum mucin levels were obtained in patients with ARDS. Statistical analysis showed an inverse correlation of serial measurements of serum mucin with static respiratory-system compliance (p = 0.021), an inverse correlation of sequential serum mucin levels and log(Pa(O2)/Fl(O2)) (p = 0.016), and a positive correlation of sequential serum mucin levels and lung injury score (LIS) (p = 0.019). Gel-filtration analysis showed that mucin-associated antigens in ARDS sera were polydispersed and smaller than the antigens in normal sera. This study indicates that an increasing amount of degraded mucin occurs in patients with ARDS.     

Diseases of the intracranial meninges: MR imaging features

Although the meninges are often thought of simplistically as a connective tissue sac that contains the CSF and the contents of the CNS, they are far more complex. Anatomically, they comprise several layers. Pathologically, numerous disease processes may affect the meninges; different processes may even involve different areas of the meninges. These factors all influence the MR imaging characteristics of meningeal lesions. This review briefly discusses the anatomy of the meninges, the MR imaging technique when meningeal disease is suspected, and the appearance of the normal meninges. It then focuses on tumors, infections, cysts, and other lesions that primarily involve the meninges, excluding lesions that secondarily involve the meninges.     

Lipoma arborescens of the knee: MR characteristics in 13 joints

We describe a technique for mapping out human somatosensory cortex using functional magnetic resonance imaging (fMRI). To produce cortical activation, a pneumatic apparatus presented subjects with a periodic series of air puffs in which a sliding window of five locations moved along the ventral surface of the left arm in a proximal-to-distal or distal-to-proximal direction. This approach, in which the phase-delay of the stimulus can be used to produce somatotopic maps of somatosensory cortex, is based on a method used to generate retinotopic maps of visual cortex. Functional images were acquired using an echoplanar 1.5T scanner and a T2*-weighted spiral acquisition pulse sequence. The periodic series of air puffs created phase-related activation in two cortical regions of the contralateral parietal lobe, the posterior bank of the central sulcus and a more posterior and lateral region.     

MR imaging of the adrenal gland: radiologic-pathologic correlation

Complex physiologic and neoplastic processes affect the adrenal glands. An appreciation of the gross pathologic and histologic correlates of disease aids in understanding the mechanisms by which diagnostic imaging helps characterize adrenal masses. Computed tomographic (CT) densitometry and chemical shift magnetic resonance (MR) imaging would seem to be the most reliable tools in determining whether a given adrenal mass is specifically an adenoma. Such a determination is made on the basis of the presence of substantial amounts of intracytoplasmic lipid. Thus, although a homogeneous mass with a CT attenuation of less than 10 HU or a decrease in signal intensity at opposed-phase MR imaging is diagnostic for adenoma, lesions that do not have these features are indeterminate and may necessitate biopsy. Adrenal myelolipoma also has a distinctive imaging appearance that reflects the presence of macroscopic fat deposits. Diagnosis of adenoma or adrenal myelolipoma is very helpful in the assessment and treatment of asymptomatic patients with adrenal masses and may make biopsy unnecessary. In patients with clinical or biochemical evidence of adrenal disease, MR imaging helps confirm the presence of a mass and allows localization and further characterization of the lesion.     

MR imaging of the corpus callosum

The corpus callosum is the major axonal commissure of the brain, connecting the two cerebral hemispheres and providing communication between the cortical and subcortical neurons. With MR imaging in the sagittal plane, the corpus callosum can be depicted in great detail. We review the normal anatomy, development, and process of myelination of the corpus callosum. The MR features of various pathologic conditions involving the corpus callosum are described. Finally, we discuss the evolving role of MR imaging in neuropsychiatric diseases with respect to the corpus callosum.     

Breast disease: dynamic spiral MR imaging

The cochleo- and tonotopic organization of the second auditory area (AII) was investigated in cats anaesthetized with pentobarbital using a combination of macro- and microelectrode recording technique. The results obtained following electrical stimulation of the neural fibres innervating different regions of the organ of Corti indicate the existence of two complete representations of the cochlea in area AII: one in the dorsocaudal portion, the other in its ventrorostral portion. These two cortical representations of the cochlea differ in size and spatial orientation. The dorsocaudal projection area extends over a distance of 2.6-3.2 mm from the basal to the apical focus and is arc-shaped. The spatial orientation of cochlea representation within the dorsocaudal region of AII is similar to that described in AI, in that stimulation of the cochlea base results in maximal responses in the more rostral portion of AII and stimulation of the apex evokes cortical responses more caudally. The ventrorostral region within AII is smaller (1.4-2.5 mm length), and has the opposite cochleotopic orientation (base and apex stimulation represented caudally and rostrally, respectively). In both AII zones, there was a proportionally greater cortical representation of basilar membrane than of middle and apical portions. Although two distinct zones with the overall cochleotopic pattern described above were noted in all cats, their precise size and location considerably varied in different animals. Using microelectrode recordings, a cortical tonotopic organization can be observed that was consistent with and expanded on the earlier cochleotopic data. Within the dorsocaudal region of AII, neurons with higher best frequency responses were located in more rostral regions, while those with lower best frequencies were located caudally. An orderly progression of best frequency responses was noted as serial recordings carried out along the full extent of the representation. Neurons within the ventrorostral region of AII also displayed an orderly progression of best frequencies, but in the opposite direction, with higher best frequencies noted more caudally and lower best frequencies more rostrally.     

Normal placenta: gadolinium-enhanced dynamic MR imaging

PURPOSE: Many patients with urological disease do not speak English. In medical studies restricting patients to those who speak only English undermines efforts to understand disease because restrictions decrease efficiency of patient recruitment, and because language and culture are associated with variable outcomes. In Spanish speaking locations, such as South Florida, studies would suffer severe selection bias if patients were required to speak English. To allow grouping in future studies of English and Spanish speaking patients we examined the English-Spanish reliability of select instruments that measure health related quality of life in patients with urological disease. MATERIALS AND METHODS: We assembled available Spanish versions and translated English versions of questions regarding satisfaction, the American Urological Association symptom index, the University of California, Los Angeles Prostate Cancer Index and a pain inventory. We then examined English-Spanish reliability by asking bilingual men 50 years old or older to complete English and Spanish versions at the same sitting. A convenience sample was recruited from outpatients and volunteers at the Miami Veterans Affairs Medical Center and population based subjects living in largely Hispanic Hialeah, Florida. Reliability estimates were calculated with kappa coefficients for categorical data and intraclass correlation coefficients for quantitative data. RESULTS: A total of 100 subjects a median of 59 years old completed the questionnaire, including 55 born in Puerto Rico or Cuba, while the remainder were born at various sites throughout the Americas and Spain. Reliability estimates showed that kappa = > 0.81 for almost all items. For 2 items relating to health and social interactions reliability was poor, and stratification showed that poor reliability was primarily a feature of subjects in good health who are theoretically socially active. CONCLUSIONS: Almost all items tested have excellent English-Spanish reliability in a mixed sample of bilingual men. Nonreliability of 2 items relating to health and social interactions probably originates from the effect of language on perception, and invalidates English and Spanish grouping of these items. Because the sample represents many dialects of Spanish, the translations tested may be transported to other cities. In studies that use these instruments investigators can reasonably group answers from English and Spanish speaking study subjects or study the effects of acculturation on quality of life.     

Peroneus quartus muscle: MR imaging features

PURPOSE: To determine the prevalence of the peroneus quartus (PQ) muscle, to demonstrate the morphology of this accessory muscle on magnetic resonance (MR) images, and to reassess the reported association of the PQ muscle with a hypertrophic peroneal tubercle. MATERIALS AND METHODS: A retrospective review was performed of 136 consecutive ankle MR imaging studies. The origins, insertions, and variations in size of the muscle and the dimensions of the peroneal tubercle and retrotrochlear eminence were recorded. RESULTS: The prevalence of the PQ muscle was 10% (14 of 136 cases). The accessory muscle and tendon unit descended medial and posterior to the peroneal tendons. The site of insertion was variable and included the calcaneus, peroneus longus tendon, peroneus brevis tendon; and cuboid bone. The calcaneus was the insertion site in 11 cases. The accessory tendon attached to the retrotrochlear eminence of the calcaneus. In the group with the PQ muscle, the retrotrochlear eminence was significantly taller (P < .01) than in the group without the PQ muscle. CONCLUSION: Contrary to previous reports, the peroneocalcaneal variant of the PQ muscle appears to insert in the retrotrochlear eminence of the calcaneus rather than the peroneal tubercle. The presence of the PQ muscle is associated with a prominent retrotrochlear eminence but not with an enlarged peroneal tubercle.     

Dilated fallopian tubes: MR imaging characteristics

A complex of four proteins isolated from neuronal membranes has ligand binding sites for N-methyl-d-aspartate (NMDA) receptor agonists and antagonists and forms NMDA-activated ion channels upon reconstitution into lipid membranes. In this study, the cDNA of a subunit of this complex containing binding sites for the competitive antagonists of NMDA receptors was cloned. The cDNA clone coded for a protein of 719 amino acids (78.9 kDa). The expressed protein had binding activity for the agonists l-[3H]glutamate and [3H]glycine, the antagonist (+/-)-[3H]-(E)-2-amino-4-propyl-5-phosphonopentanoic acid ([3H]CGP 39653), but not the ion channel inhibitors. The cloned cDNA had no homology to other cloned cDNAs. Northern blot analyses indicated high expression of an 3.8 kb poly(A+) RNA in brain, but not in other tissues. These findings indicate that proteins that have recognition sites for NMDA receptor activators and inhibitors and that differ from the well-characterized NMDA receptor proteins NR1-3 are expressed in mammalian brain.