A novel approach to improve undergraduate surgical teaching

Background:

Undergraduate surgery is at an important crossroads. Many departments report significant difficulties delivering effective teaching. Our student feedback indicated a dated surgical curriculum lacking structure, quality and uniformity. We report on a new ”blended” approach employing a combination of professional DVDs, case based discussions, online material and traditional bedside teaching designed to provide structure, standardization, and equality of learning .

Methods:

Year 4 students who had undertaken the new course and year 5 students who had participated in the traditional teaching programme were compared. Students completed a 20 item questionnaire about their experiences of the surgical teaching programme.

Results:

One hundred and seventy-one year 4 (70%) and148 year 5 students (66%) responded. Domains relating to “Overall Satisfaction with the course”, “Approval of innovative teaching methods and interactivity” and “Satisfaction with the clarity of course information” showed improvements when comparing the new and old programmes. However bedside teaching was not rated as highly in the new programme (p<0.05).

Conclusion:

This blended approach has resulted in improved student understanding and engagement. The apparent compromise of bedside teaching may be a reflection of higher expectations. We believe that a similar blended approach has the potential to re-invigorate surgical teaching elsewhere.     

Target antigens of malaria transmission blocking immunity exist as a stable membrane bound complex

Monoclonal antibodies (MoAbs) blocking transmission of malaria by blocking fertilization of female gametes by male gametes in the mosquito midgut immunoprecipitate three polypeptides (apparent non-reduced mol. wt of 230,000, 48,000, 45,000) from the surface of gametes and zygotes of Plasmodium gallinaceum and P. falciparum. Earlier studies have shown that the epitopes with which the MoAbs react are present only on the mol. wt 230,000 polypeptide in P. gallinaceum and the 48,000/45,000 mol. wt antigens in P. falciparum (Kumar 1985, Vermeulen et al. 1985). In gel permeation chromatography all three polypeptides were found to be co-eluted. Cross-linking reagents were used to cross-link proteins on the intact cells and in the soluble extracts. The cross-linked product immunoprecipitated by the MoAbs showed an approximate mol. wt of 290,000 to 300,000, suggesting a stoichiometry of 1:1 between the high and low mol. wt polypeptides. Evidence was also obtained for the existence of a subpopulation of the 48,000/45,000 mol. wt polypeptides which is not complexed with the 230,000 mol. wt polypeptide. These data indicate that the 230,000 polypeptide is physically associated with the 48,000 and 45,000 polypeptides; the high and low molecular weight polypeptides appear to exist in a stable membrane bound complex.     

Apoptosis of human tongue squamous cell carcinoma cell (CAL-27) induced by Lactobacillus sp. A-2 metabolites

Objective

To study the effect of Lactobacillus sp. A-2 metabolites on viability of CAL-27 cells and apoptosis in CAL-27 cells.

Methods

Lactobacillus sp. A-2 metabolites 1 and 2 (LM1 and LM2) were obtained by culturing Lactobacillus sp. A-2 in reconstituted whey medium and whey-inulin medium; the cultured CAL-27 cells were treated with different concentrations of LM1 and LM2 (0, 3, 6, 12, 24, 48 mg/mL) and assayed by methyl thiazolyltetrazolium (MTT) method; morphological changes of apoptotic cell were observed under fluorescence microscopy by acridine orange (Ao) fluorescent staining; flow cytometry method (FCM) and agarose gel electrophoresis were used to detect the apoptosis of CAL-27 cells treated LM1 and LM2.

Results

The different concentrations of LM1 and LM2 could restrain the growth of CAL-27 cells, and in a dose-dependent manner; the apoptosis of CAL-27 cells was obviously induced and was time-dependent.

Conclusions

Viability of CAL-27 cells was inhibited by Lactobacillus sp. A-2 metabolites; Lactobacillus sp. A-2 metabolites could induce CAL-27 cells apoptosis; study on the bioactive compounds in the Lactobacillus sp. A-2 metabolites and their molecular mechanism is in progress.     

EDITORIAL. MEASURING QUALITY OF LIFE AMONG THE ELDERLY IN DEVELOPING COUNTRIES

A developing country perspective with respect to quality of life (QOL) needs to be understood despite the ambiguity that surrounds concepts of ‘QOL’, ‘elderly’ and ‘developing countries’. This editorial focuses on the demographic and epidemiologic transition, conceptual and methodological issues in measuring QOL.     

Left Septal Atrial Tachycardias: Electrocardiographic and Electrophysiologic Characterization of a Paraseptal Focus

Left Septal Atrial Tachycardias. Objective: The objective was to characterize the electrocardiographic and electrophysiological features of focal atrial tachycardia (FAT) originating from the left septum (LS). Background: FAT is recognized to occur at predefined anatomic locations rather than randomly throughout the atria. We describe the ECG and EP features of ATs originating from the LS as an important site for apparent perinodal tachycardias. Methods: Nine patients presenting with LS FAT from a consecutive series of 384 underwent EP/RFA for symptomatic FAT. Results: The mean age was 56 ± 12 years; 7 female with symptoms for 36 ± 28 months. P wave morphology (PWM) was negative/positive in lead V1 and across the precordial leads and negative or negative/positive in inferior leads in all patients. Tachycardia was incessant in 6 out of 9 patients with a mean tachycardia cycle length 421 ± 56 milliseconds. His A was ahead of P wave in all patients (mean ?15 ± 5 milliseconds) and earlier than CS proximal (mean 4 ± 9 milliseconds). Successful acute focal ablation achieved at a mean of 31 ± 12 milliseconds ahead of P wave with no recurrences at a mean follow‐up of 30 ± 28 months. Conclusion: Although the left septum is an uncommon site for focal AT an awareness of this location for harboring foci is particularly important when mapping apparently right‐sided septal tachycardias. (J Cardiovasc Electrophysiol, Vol. 24, pp. 413‐418, April 2013)     

Conformational studies of a synthetic cyclic decapeptide fragment of rat transforming growth factor-α

The solution conformation of a synthetic cyclic decapeptide [with sequence mimicking the third disulfide loop of rat transforming growth factor-α (rTGF-α)] in deuterated dimethyl sulfoxide was studied by 2D NMR. The determination of solution structures was based on NOE interproton distances, using a combination of distance geometry and simulated annealing protocols. The convergence of the selected structures was evident from the small atomic pairwise root-mean-square deviation values among them. Good agreement was noted between the experimental and simulated NOESY spectra, thereby reflecting the accuracy of the calculated solution structures. Analysis of the structures indicates that the residues Tyr5 and Arg9 exhibit similar side chain orientation as that in the corresponding disulfide loop of human transforming growth factor-α.     

Lymphangiography in Tuberculous Lymphadenitis

A rare lymphangiographic feature of tuberculous lymphadenitis in a patient who was investigated for generalised lymphadenopathy is presented.