The future of pathology: a Delphi study by pathology department chairmen

This paper reports the results of a study by and of chairmen of pathology departments in American and Canadian medical schools directed toward discovering chairmen's perceptions and attitudes about the future of pathology. Over 100 of a total of 143 chairmen participated in some or all phases of this study in which the Delphi approach was used. Sixty-five chairmen completed all four rounds of questionnaires. Most chairmen are deeply concerned about increasing federal regulation of medicine. They expect to play a greater role in all phases of medical education with more emphasis on the basic science aspects of pathology. They also foresee a desirable shifting of residency training programs away from small hospitals to the larger medical centers. This shift will result in fewer but longer training programs.     

Longitudinal ureteral split for retroperitoneal fibrosis with ureteral involvement

Idiopathic retroperitoneal fibrosis may rarely invade the ureteral wall, thereby rendering the attempt to perform classical ureterolysis futile. Possibilities for surgical correction include resection with end-to-end anastomosis, utilization of a spiral strip of ureter, small bowel substitution, iatrogenic nephroptosis or longitudinal incision of the involved ureter down to the mucosa. Two patients treated using the latter technique have been followed for 7 months and 132 months without recurrence of the obstructive process. The surgeon, when treating idiopathic retroperitoneal fibrosis, must be prepared to treat intrinsic ureteral involvement using the most appropriate surgical technique.     

A simple and sensitive experiment for measurement of JCC couplings between backbone carbonyl and methyl carbons in isotopically enriched proteins

A simple 2D difference experiment is described that allows quantitative measurement of 13C-13C J couplings between backbone carbonyl and side-chain carbons. Precise 3JCC values were measured from data recorded in just 2 h for a 1-mM solution of the 20-kD complex between the protein calmodulin and a 26-residue synthetic peptide. The J couplings aid in determining the chi 1 angles of valine, isoleucine and threonine residues, and in making stereospecific assignments of the Val C gamma methyl groups. Error analysis indicates that the uncertainty in the derived J couplings is generally less than ca. 0.3 Hz.     

Neck strain in car occupants. The influence of crash-related factors on initial severity

OBJECTIVE: To examine the relationship between the initial severity of neck strain in car occupants and crash-related factors, in particular, crash severity. DESIGN/PARTICIPANTS: Thirty-two individuals with neck strain after a car crash, drawn from physiotherapy and general practices in metropolitan Adelaide, were interviewed about their experience and examined by a manipulative physiotherapist. Crash severity was assessed by measurement of damage to the involved vehicles. MAIN OUTCOME MEASURES: Five measures of neck strain severity were obtained: number of body regions with symptoms, number of positive responses to palpation, cervical range of motion, subject's own rating on an analogue pain scale, and examiner's severity rating. Two measures of crash severity were used: maximum residual deformation, and velocity change of the subject's vehicle. RESULTS: Neck strain was observed in individuals who were involved in crashes of low severity. Maximum residual deformation of the vehicle was negatively associated with the subject's cervical range of motion and positively associated with the other measures of neck strain severity. For rear impacts, both measures of crash severity were associated with measures of neck strain severity. The group of subjects who were aware of the impending collision had a greater range of cervical spine movement and fewer positive responses to palpation than those who were unaware. CONCLUSIONS: Initial severity of neck strain is positively correlated with crash severity. Awareness of the impending collision may have a mitigating effect on injury severity.     

Stratigraphy, paleomagnetism, geochronology and structure of silicic volcanic rocks, Waiotapu/Paeroa range area, New Zealand

The altered ignimbrite sequence underlying the Waiotapu Geothermal Field has long been correlated with unaltered ignimbrite sequences exposed in the Ngapouri and Paeroa fault-scarps to the west. Recent age-dating (fission-track and K-Ar) and magnetic polarity studies have indicated this correlation is invalid.The Paeroa Scarp section comprises three major ignimbrites (Paeroa, Te Weta and Te Kopia) erupted between 0.34 and 0.38 Ma ago from local caldera sources. The Caldera Boundary Fault (CBF) marking the eastern boundary of the Paeroa Caldera crosses the northern Paeroa Range between the Waiotapu and Waikite thermal areas. East of the CBF, the Ngapouri Scarp section comprises the Waiotapu Ignimbrite (0.58 ± 0.03 Ma) unconformably overlying a reversely magnetised sequence of late Matuyama age ignimbrite (Akatarewa A) and epiclastic tuff (Unit X), intruded by rhyolite (Ngapouri Rhyolite). Episodic caldera collapse has spalled exotic blocks of Waiotapu Ignimbrite and Ngapouri Rhyolite into the caldera, where they form a discontinuous layer between two sheets of Paeroa Ignimbrite.In the Waiotapu Geothermal Field - separated from the Ngapouri Ridge by a younger rhyolite dome - the Waiotapu Ignimbrite is underlain by Akatarewa ignimbrites (A,B) separated by epiclastic tuffs (Unit Y) overlying a truncated andesite cone (Ngakoro Andesite) and an older unnamed Ignimbrite C; all are of late Matuyama age, possibly extending back to the Jaramillo sub-chron.Younger sheets of Rangitaiki (0.35 ± 0.03 Ma), Matahina (0.28 ± 0.04 Ma), Ohakuri (0.27 ± 0.03 Ma) and Kaingaroa (0.22 ± 0.04 Ma) ignimbrite were emplaced across the area, the latter from the nearby Reporoa Basin (caldera). The progressive uplift of the Paeroa and Ngapouri tilted fault-blocks and further subsidence of the Reporoa Basin allowed the accumulation of thick lake beds (Huka Group) which capped geothermal reservoirs, originally established and later rejuvenated by episodic caldera formation. Present-day upflow zones are largely concentrated by active faults and fault intersections breaching the cap-rocks. Hydrothermal eruptions from self-sealed shallow reservoirs throughout the Waiotapu-Waikite area were commonly initiated by volcanic and/or tectonic events on major faults cutting and linking major calderas.