Are the dinosauromorph femora from the Upper Triassic of Hayden Quarry (New Mexico) three stages in a growth series of a single taxon?

ABSTRACT The lagerpetid Dromomeron romeri and the theropod Tawa hallae are two dinosauromorphs from the Norian (Upper Triassic) of the Chinle Formation, situated in New Mexico, USA. However, a recent study suggests the inclusion of the holotype of D. romeri (GR 218) and paratype (GR 155) and referred (GR 235) specimens of T. hallae in an ontogenetic series of a single species. The specimens GR 218 and GR 155 include just an isolated femur, while GR235 includes femora, pelvis and tail. The inclusion of the specimens in an unique ontogenetic series relies on the putative immature condition and plastic deformation of the specimen GR 218. However, as observed here, the disparity between the femora of D. romeri and T. hallae is considerably higher than those expected from the ontogenetic variance in dinosauromorphs. In addition, D. romeri shares an unique suite of traits with Dromomeron gigas, a species known from a mature specimen. Therefore, the high disparity between D. romeri and T. hallae, lack of traits shared solely between the three femora, and a suite of traits shared between D. romeri and D. gigas, precludes the inclusion of the three femora from Hayden Quarry in a growth series of a single taxon.

Utilization and purchase of medical care services in Mexico by residents in the United States of America, 1998-1999

OBJETIVOS: Evaluamos la frecuencia con que habitantes del sur del estado de Nuevo México, Estados Unidos, autoinformaron de la frecuencia con que compraban medicamentos y servicios médicos en México y examinamos dicha frecuencia a la luz de su cobertura con un seguro médico. MÉTODOS: Analizamos los datos obtenidos en 1998 y 1999 mediante una entrevista de salud de residentes de una región de seis condados en Nuevo México, usando métodos de prevalencia y regresión logística para datos de encuesta complejos. RESULTADOS: Cerca de 22% de los residentes de la parte sur del estado de Nuevo México habían comprado medicinas y 11% habían buscado atención médica en México por lo menos una vez en el transcurso del año que precedió a la encuesta. Cuando se hicieron ajustes en función de los efectos de otras variables, las personas que podían pagar los servicios de su propio bolsillo y las que no tenían seguro eran más propensas a comprar medicinas o atención médica en México que las que tenían cobertura médica completa. CONCLUSIONES: Muchas personas que habitan cerca de la frontera en el estado de Nuevo México viajaban hacia el sur hasta México para comprar medicinas y atención médica. La falta de seguro médico estuvo asociada con una compra más frecuente de ambas cosas. Parece haber una necesidad de establecer relaciones entre los planes de seguro médico estadounidenses privados y públicos y los proveedores de servicios médicos mexicanos con el fin de identificar mecanismos apropiados para que los residentes de Estados Unidos puedan comprar atención médica en México.

Disseminated Coccidioidomycosis Presenting with Miliary Nodules / 결핵및호흡기질환

Coccidioidomycosis is a rare systemic fungal infection in Korea. However, the incidence of coccidioidomycosis has recently begun to increase due to the increasing incidence of people traveling overseas to endemic areas. In previously reported cases of coccidioidomycosis in Korea, the radiographic findings usually showed a solitary pulmonary nodule, pleural effusion, cavitation, and hilar lymphadenopathy, but no miliary nodules. We report a case of disseminated coccidioidomycosis with miliary nodules in an immunocompetent patient. A 32 year old male, who had traveled in Corona, New Mexico, USA, was admitted for an evaluation of persistent cough with fever. Chest radiography revealed initially diffuse multiple small nodules that appeared to be miliary tuberculosis. However, a subsequent evaluation revealed that he had disseminated coccidioidomycosis.

Disseminated Coccidioidomycosis Presenting with Miliary Nodules / 결핵및호흡기질환

Coccidioidomycosis is a rare systemic fungal infection in Korea. However, the incidence of coccidioidomycosis has recently begun to increase due to the increasing incidence of people traveling overseas to endemic areas. In previously reported cases of coccidioidomycosis in Korea, the radiographic findings usually showed a solitary pulmonary nodule, pleural effusion, cavitation, and hilar lymphadenopathy, but no miliary nodules. We report a case of disseminated coccidioidomycosis with miliary nodules in an immunocompetent patient. A 32 year old male, who had traveled in Corona, New Mexico, USA, was admitted for an evaluation of persistent cough with fever. Chest radiography revealed initially diffuse multiple small nodules that appeared to be miliary tuberculosis. However, a subsequent evaluation revealed that he had disseminated coccidioidomycosis.

A case of megacolon in Rio Grande Valley as a possible case of Chagas disease

We have been searching for evidence of Chagas disease in mummified human remains. Specifically, we have looked for evidence of alteration of intestinal or fecal morphology consistent with megacolon, a condition associated with Chagas disease. One prehistoric individual recovered from the Chihuahuan Desert near the Rio Grande exhibits such pathology. We present documentation of this case. We are certain that this individual presents a profoundly altered large intestinal tract and we suggest that further research should focus on confirmation of a diagnosis of Chagas disease. We propose that the prehistoric activity and dietary patterns in Chihuahua Desert hunter/gatherers promoted the pathoecology of Chagas disease

A Case of Coccidioidomycosis Manifested as Solitary Pulmonary Nodule / 결핵

Coccidioidomycosis is a fungal infection acquired by inhalation of the arthrospore of Coccidioides immitis, and endemic disease in specific geographic areas, such as south central California, south Arizona, Nevada, and New Mexico. Approximately 60 percent of infected people is asymptomatic and the remainders mostly exhibit respiratory complaints, from flu-like coughing to overt pneumonia. Usually the infection due to Coccidioides immitis is self-limited. Symptoms resolve within several weeks but radiographic abnormalities could be resolved more slowly. If the radiographic abnormalities persist more than 8 weeks, the term 'chronic pulmonary coccidioidomycosis'is designated. They take forms of nodules, cavities or progressive pneumonia. When manifested as nodule(s), lung malignancy is suspected as a possible diagnosis and histologic confirmation is needed. Here, we report a case of chronic pulmonary coccidioidomycosis manifested as solitary pulmonary nodule in a Korean woman who has traveled in Arizona, which is diagnosed fianlly by lobectomy and histologic examination.

Clinicopathological Analysis on the 104 Cases of Malignant Melanoma

The cliniopathological analysis was done on the 104 cases of malignant melanoma diagnosed at the Seoul National University Hospital (SNUH) from 1984 to 1993. The basic clinical data and the pathological items were based on the New Mexico Melanoma Registry Worksheet. The results were as follows. The male to female ratio was 1 : 0.79. Primary cutaneous melanoma was more common in the male (M : F=1 : 0.56) but primary extracutaneous melanoma with slight female dominancy (M : F=1 : 1.25). The peak age was the 6th decade in both cutaneous and extracutaneous malignant melanoma. In 66% (35 cases) of primary cutaneous malignant melanoma, the primary site was located in the acral area (including cases of acral lentiginous and nodular type), of which 63% (41% of total cutaneous melanoma) was acral lentiginous type. Major components of tumor cells were epithelioid. Clark's level of tumor was III or more at the time of the first visit in the majority of the cases (85%). The incidence rate of extracutaneous melanoma was 34.6% (36 cases) among the primary melanoma, and the eyeball (17.3%) was the most prevalent organ. All these features suggest that the racial difference between the Korean and the Caucasian is evident and also that etiologic role of sun damage is not quite marked in the Korean. We also suggest that an early detection program is very important to cure this malignant tumor.

Comparative Study of Problem Based Learning(PBL) Experiences in Different Learning Groups / 한국의학교육

Problem-based learning(PBL) is widely used as an effective educational tool; the fields in which it has been applied include medicine. Several reports have described the results of trials comparing problem-based and conve ntional approaches to learning; none, however, have compared the results between two groups where one had not undergone medical training, and the other had been partially trained, using the conventional approach. The aim of this study was to determine whether there was any difference in medical performance between two groups, as described above. Before the possible incorporation of PBL into our curriculum, we also wished to investigate many possible problems. Group A consisted of five premedical school students and group B of six students in the first year of medical school at our college. The same case which had been used in the tutor training program in the University of New Mexico School of Medicine was used by the same tutor who attended that program, and the whole procedure was evaluated by other faculty members through closed-circuit TV monitor. We also analyzed the results of evaluation by the tutors and students themselves. The general performance of the students was excellent, while the performance of the tutors were acceptable. Many possible problems, including library facilities and educational environments were also discussed. In conclusion, PBL is an approach which can be used in our medical college from an early stage. Before it is fully introduced, however the large number of potential problems should be carefully evaluated.

The role of Hispanic race/ethnicity and poverty in breast cancer survival

The association of Hispanic race/ethnicity and poverty with general survival time and breast cancer survival time was examined for a total of 14,896 breast cancer patients (14,035 White and 861 Hispanic) included in the National Cancer Institute Surveillance Epidemiology and End Results (NCI SEER) program in New Mexico and San Francisco between 1975 and 1984. Variables examined included: age, marital status, stage at diagnosis, tumor histology, delay, treatment, period of diagnosis (1975-79 vs. 1980-84), and poverty. Univariate analysis of 14,896 patients indicated that a greater proportion of Hispanics (vs. Whites) with breast cancer were: younger than age 50, married, diagnosed at a later stage, diagnosed in New Mexico, lived in greater poverty, were diagnosed between 1980-84, and died from breast cancer. Univariate Cox Proportion Hazards analysis indicated that poverty was a significant predictor for reduced general survival time. Being diagnosed in the 1980-84 period was a predictor for improved general survival time. Poverty and Hispanic race/ethnicity were significant predictors of reduced breast cancer survival time. Multivariate Cox Proportional Hazards models indicated that Hispanic race/ethnicity was a significant risk factor for breast cancer survival time for women aged 50 and older. For White women: state, marital status, poverty, surgery, radiation/hormonal treatments, and histology were significant risk factors for breast cancer survival time. For Hispanic women: stage, surgery, hormonal treatment and period of diagnosis were significant risk factors for breast cancer survival time. For White breast cancer patients, period of diagnosis was not a significant risk factor for reduced breast cancer survival time; but for Hispanics, it was a significant risk factor. In the age and race/ethnicity-stratified models of breast cancer survival time, similar risk factors emerged for both Whites and Hispanics. For both younger and older Hispanics, being diagnosed in the early 1980's (vs. the late 1970's) was associated with reduced breast cancer survival time--vs. Whites, who experienced no significant change in breast cancer survival time in the same time period. Poverty was not a predictor for Hispanic survival time in any of the models; however, it was a predictor for younger Whites for breast cancer survival time. These results fueled discussion in three areas targeting breast cancer in underserved women: the development of racial/ethnic-specific cancer control guidelines, the development of a breast cancer integrated delivery system, and population management

Melanoma maligno en Puerto Rico / Malignant melanoma in Puerto Rico

Se efectuó un estudio epidemiológico de melanoma maligno mediante la revisión de todos los casos de melanomas reportados al Registro de Cáncer de Puerto Rico entre los años 1981 al 1987. Se documentaron un total de 367 casos nuevos con una incidencia anual que fluctuó entre 1.20 y 2.12 por 100,000 habitantes y un promedio de 1.59. La mayoría de los pacientes tenín entre los 40 y 80 años de edad, con una mayoría en los 60. Casi la mitad de los tumores ocurrieron en las extremidades, sobre todo en los pies, compartiendo esta tendencia con otras razas como los negros y japoneses. El tipo clínico-histológico más frecuente lo fue el melanoma superficial expansivo seguido del acral lentiginoso , el nodular y el melanoma lentigo maligna. Cerca de un tercio del total de casos no fue clasificado de acuerdo al tipo histológico, mientras que los niveles de Clark y el grosor de Breslow no fueron reportados en 44 y 84% de los casos respectivamente. Cuando comparamos nuestra data a la de un estudio previo en Puerto Rico entre los años de 1977 al 1980, la incidencia anual promedio de casos nuevos aumentó de 0.92 a 1.59 por 100,000 habitantes, documentándose un aumento de incidencia en nuestra población, pero no tan significativo como el aumento registrado en los Estados Unidos