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Professions. S. Kuntz, A. Larson, and M. Laxen, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota Background: The physician assistant program at the University of North Dakota UND ; has previously only admitted registered nurses with a minimum of three years experience. Beginning in fall 2006, the program began a three-year pilot program to allow individuals with other allied health profession backgrounds to enter the program. The university program is planning intensive evaluation of how the new candidates are prepared to enter and perform during this unique program that has previously been designed around nursing professionals' background and experiences. The initial set of data was collected during the fall orientation program and consisted of the completion of the Diagnostic Thinking Inventory Bordage, Grant, & Marsden, 1990 ; . This is a pre-test of the students' diagnostic reasoning and will be compared to a post-test of the same inventory at the end of the program. Purpose: Identify potential differences between student group scores nursing versus non-nursing professionals ; on the subcategories of the Diagnostic Thinking Inventory: 1 ; flexibility in thinking, 2 ; evidence for structure in memory, as well as their overall combined score. Methods: The participants are the 32 students enrolled in the 2006-2008 university PA program, of which 18 are registered nurses and 14 come from other allied health professions. Data from the flexibility in thinking, evidence for structure in memory, and overall combined scored will be analyzed using t-tests assuming equal variances. The .10 level of sensitivity will be utilized due to low power .490 ; , resulting from the low number of participants. Additionally, the data will be analyzed for between-subjects effects using the independent variables of marital status, gender, age, and years in a health profession. Results: T-tests did indicate significantly higher differences in the nursing subgroup of students with the evidence for structure in memory t-test 2.000, df 30, p .055 ; and overall combined score t-test 1.936, df 30, p .062 ; , but no significant difference between the groups on the flexibility in thinking score t-test 1.187, df 30, p .245 ; . There were no significant differences between subject effects for marital status F .519, df 30, p .477 ; , gender F .093, df 30, p .762 ; , age F .022, df 30, p .884 ; , and years in allied health profession F 2.737, df 30, p .109 ; . Conclusions: The registered nurses appear to have a slight advantage with the structure of their learning in their memory, but it is only a slight difference. This may be biased due to the low number of students enrolled in the trial program. Both groups appear to be equally flexible in their diagnostic thought. It is recommended that these results be compared to standardized clinical performance data, objective testing results, and diagnostic post-testing to see if the two student groups are comparable at the completion of the program. The data will allow UND to modify curriculum as necessary to meet the needs of the new allied health professional program participants.
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NMR evidence indicates that both deoxyschizandrin 56 and its isomer 59 adopt a twist-boat-chair conformation 60. Of more interest is the fact that two stable conformers of 55 are formed and can be isolated. However, while it seems generally agreed that the minor conformer is the twist-boat-chair. MALIGNANT MEDIASTINAL TUMORS: SURGERY, HISTOLOGY, AND SURVIVAL Jozsef Furak, MD * ; Imre Trojan, MD; Tamas Szoke, MD; Laszlo Tiszlavicz, MD; Adam Balogh, MD. University, Univ. of Szeged, Szeged, Hungary PURPOSE: To establish the distribution of malignant mediastinal tumors according to histological structure, surgery, location and age. METHODS: Between 1992 and 2002, 71 patients were operated on for 54 anterior, 6 middle and 11 posterior mediastinal tumors. 17 of the 54 tumors were malignant. 16 94% ; of the malignant tumors were located in the anterior, and 1 6% ; in the posterior mediastinum. They were 10 females and 7 males; average age 42.6 years 13-68 ; . The surgical approaches were 8 median sternotomies, 8 posterolateral thoracotomies, and for a dumb-bell tumor it was a combined exposure posterior laminectomy, followed by left posterolateral thoracotomy ; . In 5 cases, the tumor could be removed only with extended resection 1 lobectomy with chest wall resection, 2 wedge resections, 2 pericardial resections ; . RESULTS: Histology revealed an Askin tumor in the posterior mediastinum, 11 invasive thymomas, 2 thymus epithelial carcinomas, 1 thymus lymphoma, 1 malignant teratoma and 1 liposcarcoma in the anterior mediastinum. 13 patients received postoperative irradiation, 3 chemoradiotherapy, and 1 chemotherapy. 16 30% ; of the 54 anterior mediastinal tumors and 1 9% ; of the 11 posterior mediastinal tumors were malignant, but 14 43, 7% ; of the 32 thymomas were malignant. 5-year survival of the malignant thymomas is 33%. In 4 patients, younger than 18 years old, other than invasive thymoma developed, Askin tumor, liposarcoma, lymphoma, and malignant teratoma ; and 3 of them died within a year. Myasthenia gravis appeared in 18, 7% of the thymomas, and in one case myasthenia gravis developed after a partial thymectomy. CONCLUSION: Malignant mediastinal tumor occurs most commonly in the anterior mediastinum. Almost half of the thymomas were malignant. In childhood, other than malignant thymomas developed, and the prognosis was poor. CLINICAL IMPLICATIONS: The most common location of a malignant mediastinal tumor is the thymus with good prognosis. In young patients the malignant mediastinal tumor located out of the thymus with poor survival. Myasthenia gravis may develop after partial thymectomy. DISCLOSURE: J. Furak, None and cilostazol.
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OBJECTIVES: Effective eradication of Helicobacter pylori H. pylori ; infection has often proved more difficult than expected. Antimicrobial resistance incompletely explains eradication failure. This study tests the hypothesis that an impaired immune response may contribute to failed eradication after standard antibiotic therapy. METHODS: Parameters of host immunity were assessed as blood T lymphocyte production of interferon- IFN- ; and interleukin-4 IL-4 ; being surrogate markers of mucosal Th1 and Th2 responses, respectively. The validity of using circulating T cell cytokines as surrogate markers of mucosal immunity was established unstimulated lymphocyte IL-4 level correlation r2 0.549, p 0.001; antigen-stimulated lymphocyte correlation r2 0.62, p 0.001 ; . RESULTS: A total of 52 dyspeptic patients and 11 patients with previous H. pylori eradication failure were recruited into the study. There was no significant difference in secretion of IFN- from peripheral blood T cells, in either unstimulated or antigen-stimulated cultures, between clinical groups. There was, however, a significant reduction in secretion of IL-4 from blood T cells in subjects failing to eradicate H. pylori compared with those who successfully eradicated the infection in both unstimulated and stimulated cultures. A significant difference in IL-4 secretion was also detected in antigen-stimulated cultures compared with that in H. pylori-positive subjects p 0.05 ; . Low levels of IL-4 secretion were detected irrespective of the number of courses of antibiotic therapy. Lower levels of IgG antiH. pylori antibody were detected in both serum and saliva of subjects with persistent H. pylori infection after use of antibiotics compared with untreated H. pylori-positive subjects difference not statistically significant ; . CONCLUSIONS: These results support the hypothesis that impaired mucosal immunity, particularly involving the secretion of IL-4, may contribute to H. pylori eradication failure. Measurement of whole blood secretion of IL-4 may predict which patients are more likely to fail standard antibiotic therapy. J Gastroenterol 2002; 97: 30323037. by Am. Coll. of Gastroenterology and ciprofloxacin.

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