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R Graham

Publications and source records attributed to R Graham.

At least 91 records · Page 5Linked to original sources

Entry of US medical school graduates into family practice residencies: 1992-1993 and three-year summary.

This is the 12th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each medical school's graduates entering family practice residency programs. Approximately 10.8% of the 15,466 graduates of LCME-accredited US medical schools between July 1991 and June 1992 were first-year residents in family practice in October 1992. This compares to 10.3% the previous year. This is the first increase since 1989. Medical school graduates from publicly funded medical schools were more than twice as likely to be first-year residents in family practice in October 1992 than were residents from privately funded schools, 13.8% compared to 6.4%. The Mountain region reported the highest percentage of medical school graduates who were first-year residents in family practice programs in October 1992 at 18.3%; the Middle Atlantic and New England regions continued with the lowest percentages, 5.6% and 7.8%, respectively. Approximately one in two medical school graduates entering a family practice residency program as a first-year resident in October 1992 entered a program in the same state as that of his or her medical school of graduation. The percentages for each medical school have varied substantially from year to year since the AAFP has reported this information. The average percentage for each medical school for the last three years is reported. In addition, the number and percentage of graduates from colleges of osteopathic medicine who entered ACGME-accredited family practice residency programs are reported.

Accreditation

Results of the 1993 National Resident Matching Program.

The 1993 NRMP results reveal a 19% increase in positions filled in family practice residencies compared to 1992 (2,002 versus 1,658) and a 17% increase in positions filled by US seniors (1,636 versus 1,398). Similarly, 11% more positions were filled on July 1, 1993, than 1992 (2,798 versus 2,530). This confirms a trend begun in 1992 of increased interest in careers in family practice, reversing four years of declining interest from 1988 to 1991. Two hundred one fewer US seniors matched in internal medicine, while 36 more chose pediatrics. Of students entering residency training in the generalist disciplines, it is expected that 27% of the class of 1993 (LCME-accredited medical schools) will practice as generalists. An increase of 9% of first-year positions offered, and the development of 15% new ACGME-accredited family practice residency programs, could accommodate 20% of the nation's graduates of LCME- and AOA-accredited medical schools. With increasing interest in careers in family practice, increased support for the nation's family practice residency programs is critical.

Career Choice

Delineation of a 50 kilobase DNA segment containing the recombination site in a sporadic case of Huntington's disease.

No detectable rearrangements involving chromosome 4p16.3 have been observed in patients with Huntington's disease (HD). New mutations for HD could involve structural alterations which might aid the localization of the defective gene. We have reinvestigated a well documented sporadic case of HD. DNA haplotyping with markers between D4S10 and the telomeric locus D4S141 reveals a recombination event in one chromosome of the sporadic HD patient. The site of recombination maps within a 50 kilobase (kb) region, about 700 kb from the 4p telomere. Based on the extremely low HD mutation rate and significantly decreased recombination in the distal region of 4p, we hypothesize a direct link between the site of the recombination and HD in this patient.

Adult

Cloning and mapping of the alpha-adducin gene close to D4S95 and assessment of its relationship to Huntington disease.

The genetic defect underlying Huntington's disease (HD) has been mapped to 4p16.3. Refined localization using recombinant HD chromosome analysis and allelic association analyses have identified two distinct candidate regions. Using a cDNA hybrid selection procedure we have cloned the gene for alpha-adducin, a subunit of a cytoskeletal protein crucial for spectrin-actin membrane plasticity. This gene maps to the proximal 2.2 Mb candidate region within 20 kb of D4S95. Alleles of markers at this locus have been shown to exhibit significant linkage disequilibrium with HD. A 4 kb alpha-adducin transcript was identified which is abundantly expressed in the caudate nucleus, the site of major neuronal loss in HD. Sequencing of the brain alpha-adducin cDNA from two HD patients and an age-matched control did not detect any sequence alterations specific to HD. However, we identified in brain cDNA of both patients and control samples, two alternately spliced brain exons, not previously described in the erythrocyte cDNA. A 93 bp exon is inserted in frame between codon 471 and 472 while a 34 bp exon inserted within codon 621 disrupts the frame and introduces a stop codon after 11 novel amino acids. The mapping of the adducin gene adjacent to D4S95 and its pattern of expression, as well as its potential for distinct alternately spliced variants, reinforces the necessity to accurately assess the role of the expression of this gene in the pathogenesis of HD.

Amino Acid Sequence