Graduates of foreign medical schools: demographic and personal predictors of success on an OSCE-format internship programme entrance examination.

A Discriminant Function Analysis on 233 graduates of foreign medical schools, from whom a group of 24 were selected that although several variables correlated significantly with selection, no combination of demographic variables could act as an efficient screen of clinically deficient candidates.

Hemodynamic analysis of associated extracranial atraumatic vertebral artery aneurysm and arteriovenous fistula. Case report.

A case of atraumatic arteriovenous (AV) fistula of the extracranial vertebral artery associated with an atraumatic aneurysm of the contralateral extracranial vertebral artery is reported. The fistulous lesion was excised after distal and proximal ligation of the vessel. Subsequently, the contralateral aneurysm underwent spontaneous dissolution.

Incisional adenocarcinoma after intracranial metastasis resection.

Skin and subcutaneous secondary tumors are unusual, especially in cases of colonic adenocarcinoma. They usually signify disseminated metastases. A rare case of an isolated incisional tumor after resection of a metastasis to the cerebellum is presented.

Surgical management of subaortic obstruction in single left ventricle and tricuspid atresia.

Subaortic obstruction caused by either a restrictive bulboventricular foramen in single left ventricle with an outflow chamber or by a restrictive ventricular septal defect in tricuspid atresia with transposition of the great arteries can lead to a hypertrophied, noncompliant ventricle and excessive pulmonary blood flow. This combination is disadvantageous to potential Fontan procedure candidates because they are dependent on good ventricular function and low pulmonary vascular resistance for survival. The results of surgical procedures to directly or indirectly relieve significant subaortic obstruction (gradient greater than 30 mm Hg) in 24 patients, 16 with single left ventricle and 8 with tricuspid atresia, were reviewed.

Ruptured intracranial aneurysms as a cause of subdural haematoma. Potential diagnostic pitfalls and the surgical management of the acute patient.

Seven cases of aneurysms that ruptured into the subdural space and were treated surgically are reviewed. Six out of the seven presented with signs of uncal herniation, three of them for at least for four hours or more. They all died in spite of urgent decompression and drainage.

Schwannoma presenting as lumbar disc disease in an adolescent boy.

Lumbar disc disease and spinal cord tumors occur relatively rarely in the pediatric age group. We report on a 16-year-old boy who presented with signs and symptoms of lumbar disc disease that failed to respond to conservative treatment. He was diagnosed preoperatively to have schwannoma of the S-1 root.

A cavernous sinus cavernous hemangioma. Case report.

The case of a Turner's syndrome patient with an intracavernous hemangioma is presented. The rarity of this lesion is stressed, as is surgical removal without postoperative deficit, the role of estrogens in the pathogenesis, and the clinical and radiological findings.

General practitioners' retirement plans and what influences them.

The results of a study of the attitudes of 197 general practitioners aged 55 and over towards retirement and their plans for retirement are reported. Few wished to retire very early, and only a further 40% definitely planned a clean break from practice. Nearly half planned on taking "24 hour retirement," even though most (78%) will be entitled to full pension rights.

Malignant teratoma of the parapharyngeal space in an adult: a rare lesion presenting as cervical cord compression.

The 12th case of a cervical teratoma in an adult is presented. This malignant lesion, located in the parapharyngeal space, presented clinically with signs and symptoms of a cervical cord compression secondary to metastases. The computed tomography, dynamic scan, and angiography workup of this patient is presented, and the literature is reviewed.

An application of computers to curriculum review and planning.

A computer-based curriculum data base was developed at the University of Toronto Faculty of Medicine to provide curriculum planners accurate information on what was being taught, who was teaching, and where in the curriculum subjects were being taught. In this paper, the authors report the use of the curriculum data base, its implications for curriculum management and planning, and plans for its further development and use. Applications that address problems of curriculum overlap, integration, and correlation are discussed.

Statements on career intentions as predictors of career choices.

In the study reported here, the author examined the relevance of students' statements on career intentions to predictions of career choices. Similar career intentions questionnaires were administered to the members of the 1973 University of Toronto Faculty of Medicine graduating class at the end of their first undergraduate year and three years later at graduation. Ten years after graduation, the professional activities and geographic locations of the class members were determined using available directories and registers.

Multiple intracranial aneurysms in sickle cell anemia. Report of two cases.

Neurological complications of sickle cell anemia occur in 18% to 29% of patients with homozygous hemoglobin S disease. A review of the literature yielded reports of two cases, both treated conservatively, of multiple intracranial aneurysms occurring in patients with sickle cell anemia. The authors report two cases of subarachnoid hemorrhage secondary to multiple intracranial aneurysms in patients with sickle cell anemia.

Anterolateral decompression for metastatic epidural spinal cord tumors. Results of a modified costotransversectomy approach.

Since 1981, 12 patients with epidural spinal cord compression from metastatic carcinoma have been treated surgically by a modified costotransversectomy approach for anterolateral decompression. Before surgery, all patients had received dexamethasone, and had deteriorated neurologically despite radiation therapy, chemotherapy, or steroid therapy. Postoperatively, nine patients (75%) improved neurologically and were ambulatory, two (17%) had no change in neurological status, and one patient was unchanged initially but deteriorated and died 8 weeks later.

Focal vascular headaches with focal arterial disease. An ultrasonographic analysis.

The relationship between migraine and premature stroke and heart disease has been firmly established in the literature. The probable mechanism relates to release of vasoactive agents locally that produce intimal changes and if chronic may lead to permanent changes to the artery. We have attempted to identify individuals at risk for premature stroke utilizing the highly accurate B-mode real time carotid ultrasonogram.

Carotid ultrasonography--the new "gold standard". Surgical and angiographic correlation.

Atherosclerotic plaques and high grade stenosis in the carotid circulation are responsible for symptoms of cerebral and retinal ischemia. Identification of these lesions by angiography has been the "gold standard" for which the decision of endarterectomy depended. The recent introduction of high resolution carotid ultrasonography has allowed us to compare thirty-seven surgical specimens with the results of preoperative screening with angiography.

Research approaches in health manpower development. Some alternatives.

Traditional scientific research approaches have contributed only minimally to the resolution of problems related to the educational aspects of health manpower development. It has been suggested that this lack of impact has been due mainly to the incompatibility of the traditional approaches with the phenomena of concern--naturally occurring educational, human, and social events. The problem has been addressed in considerable detail in the literature that relates to the more general view of education, and the alternative research approaches described in this article are derived from this broader-based literature.

A tracking study of 1977 medical graduates through graduate medical education in Ontario.

In this paper, the author describes the results of tracking a cohort of medical school graduates through the graduate medical education system of Ontario, Canada. The cohort consisted of the 1977 graduates of the five Ontario medical schools who entered the graduate system at some point between 1977 and 1982 and graduate trainees who had graduated in 1977 from medical schools outside Ontario. The objectives of the study were to determine what proportion of the total number of 1977 Ontario medical graduates received graduate training in Ontario; to document the flow of the trainees into and out of the Ontario graduate system; and to compare the graduate training patterns of the Ontario graduates in the cohort with the trainees from elsewhere.