We investigated cardiac morphometry 6 wk after sinoaortic baroreceptor denervation (SAD) in Long-Evans rats. SAD (n = 19) was associated with an 11% increase in the weight of the left ventricle (LV) plus septum (P < 0.001) and a 39% increase in that of the right ventricular (RV) free wall (P < 0.001), relative to sham-operated rats (n = 18). RV wall thickness was significantly increased in SAD animals, but there was no difference in the LV wall thickness and volumes of the RV and LV between groups. Constrictor responses to methoxamine and dilation responses to acetylcholine were assessed in an in vitro perfused mesenteric circulation preparation, but neither response was affected by SAD. Baroreceptor denervation was associated with marked and significant increases in the variability (2.8-fold) and daily peak (39 mmHg) levels of telemetered mean arterial pressure (MAP) and small (5%) but significant increases in the daily mean MAP level. Our results are consistent with an effect of increased MAP variability on ventricular weight but cannot rule out possible contributions from other mechanisms.

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The purpose of this study was to determine whether student devised and delivered supplemental instruction is beneficial and acceptable to first-year medical students. A student-run Supplemental Instruction Project (SIP) was developed and delivered by second-year medical students and offered free of charge to all first-year medical students at Memorial University of Newfoundland taking the Integrated Study of Disease I course in 1999 and again in 2000. Small-group tutorials focused on subject material that second-year medical students identified as 'difficult'. Five 60- to 90-minute sessions covering topics in cardiology, nephrology and respirology were offered. Student and tutor perceptions about the project were collected using anonymous questionnaires. Students were quizzed before and after each tutorial session. Post-tutorial quiz scores were significantly greater than pre-tutorial scores. Student and tutor perceptions of SIP were positive. It is concluded that the SIP is an acceptable, practical and effective method to supplement delivery of challenging material to first-year medical students.

A course is described in which the students give consideration to clinical cases as they review their current knowledge, and follow a set protocol which guided them in preparing their learning. The students are required to examine a case history, put down as key words either their first answer or the knowledge they consider they would need to answer specific questions. They then select stations at which additional information, wet specimens, models and radiological images assist them in upgrading their knowledge. They complete the exercise by writing a final answer to the questions on the case. The tutor is able through examination of the key words to determine the knowledge of the students as they enter, and confirm appropriate learning by inspection of the final answer. The students are able to identify their own deficiencies, develop strategies for thinking and learning, resulting in the acquisition of expertise in problem solving, and extend their communication skills by working with colleagues. While the course was designed for second-year anatomy teaching it could be applied to other disciplines.

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An anatomy course is presented which stresses the teaching of applied anatomy using lectures, laboratory workshops and problem-solving tutorials. Laboratory workshops include the use of prosected specimens and body imaging such as CT scan and ultrasound, but do not include dissection. The problem-solving tutorials make extensive use of clinical cases and the application of anatomical knowledge. The course is taught by anatomists and practising physicians, and needs only 98 hours of curriculum time. The performance of the students and the positive attitudes of both students and faculty are enhanced by the design of the course.

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Erythrocyte cytosolic protein expression profiles of children with unexplained hemolytic anemia were compared with profiles of close relatives and controls by two-dimensional differential in-gel electrophoresis (2D-DIGE). The severity of anemia in the patients varied from compensated (i.e., no medical intervention required) to chronic transfusion dependence. Common characteristics of all patients included chronic elevation of reticulocyte count and a negative workup for anemia focusing on hemoglobinopathies, morphologic abnormalities that would suggest a membrane defect, immune-mediated red cell destruction, and evaluation of the most common red cell enzyme defects, glucose-6-phosphate dehydrogenase and pyruvate kinase deficiency. Based upon this initial workup and presentation during infancy or early childhood, four patients classified as hereditary nonspherocytic hemolytic anemia (HNSHA) of unknown etiology were selected for proteomic analysis. DIGE analysis of red cell cytosolic proteins clearly discriminated each anemic patient from both familial and unrelated controls, revealing both patient-specific and shared patterns of differential protein expression. Changes in expression pattern shared among the four patients were identified in several protein classes including chaperons, cytoskeletal and proteasome proteins. Elevated expression in patient samples of some proteins correlated with high reticulocyte count, likely identifying a subset of proteins that are normally lost during erythroid maturation, including proteins involved in mitochondrial metabolism and protein synthesis. Proteins identified with patient-specific decreased expression included components of the glutathione synthetic pathway, antioxidant pathways, and proteins involved in signal transduction and nucleotide metabolism. Among the more than 200 proteins identified in this study are 21 proteins not previously described as part of the erythrocyte proteome. These results demonstrate the feasibility of applying a global proteomic approach to aid characterization of red cells from patients with hereditary anemia of unknown cause, including the identification of differentially expressed proteins as potential candidates with a role in disease pathogenesis.