John David Spencer

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BACKGROUND Preparing healthcare professionals for teaching is regarded as essential to enhancing teaching effectiveness. Although many reports describe various faculty development interventions, there is a paucity of research demonstrating their effectiveness. OBJECTIVE To synthesize the existing evidence that addresses the question: "What are the effects(More)
Until recently, imaging had a limited role in the preoperative assessment of perianal fistulas. Magnetic resonance (MR) imaging has been shown to demonstrate accurately the anatomy of the perianal region. In addition to showing the anal sphincter mechanism, MR imaging clearly shows the relationship of fistulas to the pelvic diaphragm (levator plate) and the(More)
1. We studied the effects of acute isocapnic hypoxia on arterial and central venous pressures, carotid and femoral blood flows and heart rate in intact and carotid denervated fetal sheep between 118 and 125 days gestation, after pre-treatment with either saline, atropine or phentolamine. Electrocortical activity (ECoG) and the incidence of fetal breathing(More)
A significant proportion of adnexal masses detected by sonography are indeterminate. Either their organ of origin is uncertain or it is unclear whether their nature is benign or malignant. MR imaging of the sonographically indeterminate adnexal mass can resolve most of these uncertainties. Most indeterminate masses result from common benign conditions and(More)
The purpose of this study was to define guidelines for endometrial cancer staging with MRI. The technique included critical review and expert consensus of MRI protocols by the female imaging subcommittee of the European Society of Urogenital Radiology, from ten European institutions, and published literature between 1999 and 2008. The results indicated that(More)
REVIEW DATE Review period January 1992-December 2001. Final analysis July 2004-January 2005. BACKGROUND AND REVIEW CONTEXT: There has been no rigorous systematic review of the outcomes of early exposure to clinical and community settings in medical education. OBJECTIVES OF REVIEW: Identify published empirical evidence of the effects of early experience in(More)
OBJECTIVE This analysis determines the importance of geography and spatial behavior as predisposing and enabling factors in rural health care utilization, controlling for demographic, social, cultural, and health status factors. DATA SOURCES A survey of 1,059 adults in 12 rural Appalachian North Carolina counties. STUDY DESIGN This cross-sectional study(More)
Magnetic resonance (MR) imaging of the sonographically indeterminate adnexal mass can be used to guide patient care and reduce the costs of investigation and treatment. Most indeterminate masses result from common benign conditions, and women with such masses can avoid unnecessary or inappropriate surgery. For the minority of women in whom indeterminate(More)
OBJECTIVE The purpose of this study was to compare dynamic contrast-enhanced MR imaging and dual-phase helical CT in the preoperative assessment of patients with suspected pancreatic carcinoma. SUBJECTS AND METHODS Thirty-three consecutive surgical candidates (20 men, 13 women; 39-81 years old) were included. MR imaging comprised fast spin-echo (TR/TE(More)