Although the characteristics of the histopathologic changes present in subjects who die with status asthmaticus are well documented, the structural changes present in subjects with mild to moderately severe asthma are not well described and the inflammatory changes in the large airways of subjects with chronic airflow limitation (CAL) and asthma have not been compared. Ten subjects with asthma, five taking inhaled corticosteroids and five taking beta 2-agonist aerosols, five subjects with CAL, and four subjects with no respiratory illness had four biopsies taken from airways 10 mm in diameter. The length of intact epithelium, thickness of basement membrane, and number of lymphocytes, neutrophils, eosinophils, plasma cells, monocytes, and mast cells in the lamina propria, bronchial smooth muscle, and submucosa were measured. Intact epithelium was present along 56% of the basement membrane in the asthmatic subjects, along 54% in the subjects with CAL, and along 84% in the control subjects. In the asthmatic subjects there was no direct relationship between the severity of asthma and the amount of epithelial cell loss or the number of inflammatory cells. The basement membrane was thickened in all asthmatic subjects but not in normal subjects or subjects with CAL. There was a significant increase in the number of lymphocytes, eosinophils, and mast cells in the asthmatic airways, particularly in the lamina propria, compared with the CAL subjects. There were no eosinophils or mast cells in any of the control subjects. The airways of subjects with CAL contained significantly more inflammatory cells than the control subjects. Subjects with asthma on inhaled corticosteroids had significantly fewer lymphocytes, eosinophils, and mast cells compared with subjects taking only beta 2-agonists.(ABSTRACT TRUNCATED AT 250 WORDS)

Vasoactive intestinal polypeptide (VIP) is a neuropeptide present in the nerve fibers of normal lungs, where it acts to relax bronchial smooth muscle. To determine its presence or absence in the lungs of patients with asthma, we examined lung tissue obtained at autopsy or lobectomy from five patients with asthma and nine without asthma. The avidin-biotin-peroxidase complex technique was used to stain tissue for immunoreactivity to VIP. At least 80 tissue sections from each patient were examined microscopically; the airway diameter ranged from 100 microns to 1.2 cm. Immunoreactive VIP was seen within nerves in more than 92 percent of the sections from the lungs of patients without asthma. No VIP was seen in any of 468 sections we could evaluate that were obtained from the lungs of patients with asthma. As a control for the nonspecific destruction of neuropeptides, immunostaining for substance P was also carried out. Abundant amounts of this neuropeptide were seen within nerves in tissue from the lungs of all patients. We conclude that in patients with asthma there is a loss of VIP from the pulmonary nerve fibers that may diminish neurogenically mediated bronchodilation. Whether this loss is a cause or a result of asthma is unclear.

BackgroundChronic neuropathic pain is a neuro-immune disorder, characterised by allodynia, hyperalgesia and spontaneous pain, as well as debilitating affective-motivational disturbances (e.g., reduced social interactions, sleep-wake cycle disruption, anhedonia, and depression). The role of the immune system in altered sensation following nerve injury is well documented. However, its role in the development of affective-motivational disturbances remains largely unknown. Here, we aimed to characterise changes in the immune response at peripheral and spinal sites in a rat model of neuropathic pain and disability.MethodsSixty-two rats underwent sciatic nerve chronic constriction injury (CCI) and were characterised as either Pain and disability, Pain and transient disability or Pain alone on the basis of sensory threshold testing and changes in post-CCI dominance behaviour in resident-intruder interactions. Nerve ultrastructure was assessed and the number of T lymphocytes and macrophages were quantified at the site of injury on day six post-CCI. ATF3 expression was quantified in the dorsal root ganglia (DRG). Using a multiplex assay, eight cytokines were quantified in the sciatic nerve, DRG and spinal cord.ResultsAll CCI rats displayed equal levels of mechanical allodynia, structural nerve damage, and reorganisation. All CCI rats had significant infiltration of macrophages and T lymphocytes to both the injury site and the DRG. Pain and disability rats had significantly greater numbers of T lymphocytes. CCI increased IL-6 and MCP-1 in the sciatic nerve. Examination of disability subgroups revealed increases in IL-6 and MCP-1 were restricted to Pain and disability rats. Conversely, CCI led to a decrease in IL-17, which was restricted to Pain and transient disability and Pain alone rats. CCI significantly increased IL-6 and MCP-1 in the DRG, with IL-6 restricted to Pain and disability rats. CCI rats had increased IL-1β, IL-6 and MCP-1 in the spinal cord. Amongst subgroups, only Pain and disability rats had increased IL-1β.ConclusionsThis study has defined individual differences in the immune response at peripheral and spinal sites following CCI in rats. These changes correlated with the degree of disability. Our data suggest that individual immune signatures play a significant role in the different behavioural trajectories following nerve injury, and in some cases may lead to persistent affective-motivational disturbances.

This study evaluates a cooperative learning approach for teaching anatomy to health science students incorporating small group and peer instruction based on the jigsaw method first described in the 1970's. Fifty-three volunteers participated in abdominal anatomy workshops. Students were given time to become an "expert" in one of four segments of the topic (sub-topics) by allocating groups to work-stations with learning resources: axial computerized tomography (CT) of abdominal structures, axial CT of abdominal blood vessels, angiograms and venograms of abdominal blood vessels and structures located within abdominal quadrants. In the second part of workshop, students were redistributed into "jigsaw" learning groups with at least one "expert" at each workstation. The "jigsaw" learning groups then circulated between workstations learning all sub-topics with the "expert" teaching others in their group. To assess abdominal anatomy knowledge, students completed a quiz pre- and post- workshop. Students increased their knowledge with significant improvements in quiz scores irrespective of prior exposure to lectures or practical classes related to the workshop topic. The evidence for long-term retention of knowledge, assessed by comparing end-semester examination performance of workshop participants with workshop nonparticipants, was less convincing. Workshop participants rated the jigsaw workshop highly for both educational value and enjoyment and felt the teaching approach would improve their course performance. The jigsaw method improved anatomy knowledge in the short-term by engaging students in group work and peer-led learning, with minimal supervision required. Reported outcomes suggest that cooperative learning approaches can lead to gains in student performance and motivation to learn. Anat Sci Educ 00: 000-000. © 2018 American Association of Anatomists.

Visuospatial skills are considered important attributes when learning anatomy and there is evidence suggesting that this ability can be improved with training techniques including drawing. The Mental Rotations Test (MRT) has been routinely used to assess visuospatial ability. This study aimed to introduce students to drawing as a learning strategy for anatomy. Undergraduate speech science anatomy students took part in a drawing tutorial (n = 92), completed an MRT test, pre‐ and post‐tutorial tests, and surveys regarding their use and attitudes toward drawing as a study tool. The impact on their examination performance was then assessed. Regardless of MRT score or attitude to drawing, students who participated in the drawing tutorial demonstrated immediate improvement in post‐tutorial test scores. Students in the drawing group performed better in most anatomy components of the examination, but the result did not reach statistical significance. There was only a positive correlation between MRT score and one type of anatomy question (non‐image‐based) and speech physics questions (r = 0.315, p = 0.002). The unexpected finding may relate to the MRT which assesses spatial rather than object visualization skills. Students who liked drawing also performed significantly better in word‐based and speech physics questions. It is likely that the style of identification question did not require the mental manipulation ability assessed in the MRT. This study demonstrated that students with lower MRT scores are not outperformed in all aspects of anatomy assessment. The study highlights the importance of a more nuanced understanding of visuospatial skills required in anatomy.