Volume 93, Issue 6

Neurologic and psychologic tests without brain tissue biopsy do not establish the diagnosis of Alzheimer's disease. This pilot study demonstrates significant increases in the activity of plasma glutamate dehydrogenase and the plasma concentrations of aspartate, glutamate, and a-ketoglutarate in nursing home residents with previously diagnosed Alzheimer's disease when compared with that in other nursing home residents without Aldzheimer's disease who had no complicating conditions. Plasma concentrations of -y-aminobutyric acid, glutamine, and activities of plasma glutamate decarboxylase, glutaminase, and glutamine synthetase were not significantly different in the two groups. A discriminant analysis number, based on the four significantly different compounds, is obtained that may be used as the basis for an inexpensive, noninvasive, and accurate screening test for Alzheimer's disease.

During the past decade, asthma morbidity and mortality have increased noticeably. Although the reasons for the increase are not clear, the prevalence of asthma has been reported to be increasing not only in the United States but also in other countries throughout the world, including the United Kingdom, New Zealand, and Australia. Asthma mortality rates and morbidity trends are increasing despite what appears to be major scientific advances in our understanding of asthma and in the face of a multitude of new therapeutic modalities. This article presents a brief overview of the pathogenesis and diagnosis of asthma, and highlights the major management recommendations of two expert panel reports.

Many problems exist within the contemporary medical education process in general and the osteopathic medical profession in particular. Part 2 of this series suggests that the single greatest impediment to solving these problems is an institutional infrastructure that is not congruent with the institution's functions, as defined in its mission statement. (This mission statement generally entails two primary goals: education and research.) Two major divisions within the core's infrastructure are suggested: medical education and medical research. By restructuring their infrastructure, colleges of osteopathic medicine can more effectively address and support their primary functions of education and research.

Classroom facilities in teaching hospitals have evolved from simple rooms with blackboards to sophisticated amphitheaters with high-tech audiovisual equipment. This article presents a ''blueprint,'' which was used in an osteopathic hospital, to renovate existing space into classrooms that are conducive to learning.

Metered-dose inhalers are frequently used in treating pulmonary diseases associated with bronchoconstriction, chiefly asthma and chronic bronchitis. These aerosolized medications are not without the potential for adverse effects. The author describes two patients who likely had adverse reactions to the Freon propellants used in the inhalers. These reactions are reported in order to alert physicians to their possible occurrence and to suggest a rational treatment approach.