Scale to measure medical, nursing and midwifery students' engagement in an e-learning histology course / Escala para medir la participación de estudiantes de medicina, enfermería y obstetricia en un curso de histología e-learning

SUMMARY: E-learning courses become increasingly important and relevant in medicine and health sciences over the last decade. However, there are few teaching experiences of e-learning histology courses published in the literature worldwide. Moreover, most of these studies focus on the didactic aspects of the course without exploring student participation. The study presented below aimed to validate a scale to measure student participation in an e-learning histology course. We provide evidence of validity of the instrument based on its internal structure for use with medical, nursing, and midwifery students. The participants in this study were a group of 426 Chilean medical, nursing and midwifery students from a public university who completed the questionnaire in two consecutive semesters (2020-2021). Data from the first group of students were used to perform an exploratory factor analysis (EFA), while data from the second group of participants were used to perform a confirmatory factor analysis (CFA). The three factors identified according to the CFA were: "Habits of online," "Motivation for online learning," and "Interaction of online". After eliminating one of the initial items of the instrument, the scale showed acceptable psychometric properties suggesting that it is a useful instrument to measure students' perception of their participation in e-learning histology courses. The factors identified through the validation of the instrument provide relevant information for teachers and curriculum developers to create and implement different ways of encouraging student participation in e- learning histology courses to support online learning.

Los cursos e-learning han tomado mayor importancia y relevancia durante la ultima década en carreras de medicina y ciencias de la salud. No obstante, existen escasas experiencias docentes de cursos de histologia e-learning publicadas en la literatura mundial. Además, la mayoría de estos estudios se centran en los aspectos didácticos del curso sin explorar la participación de los estudiantes. El estudio que presentamos a continuación tuvo por objetivo validar una escala para medir la participación de los estudiantes en un curso de histología e-learning. Aportamos evidencia de validez del instrumento basada en su estructura interna para su uso con estudiantes de medicina, enfermería y obstetricia. Los participantes de este estudio fueron un grupo de 426 estudiantes chilenos de medicina, enfermería y obstetricia de una universidad pública quienes completaron el cuestionario en dos semestres consecutivos (año 2020-2021). Los datos del primer grupo de estudiantes se utilizaron para realizar un análisis factorial exploratorio (AFE), mientras que los datos del segundo grupo de participantes se utilizaron para realizar un análisis factorial confirmatorio (AFC). Los tres factores identificados según el AFC fueron: "Hábitos de los estudiantes en línea", "Motivación por el aprendizaje en línea", "Interacción de los estudiantes en línea". Luego de la eliminación de uno de los ítems iniciales del instrumento, la escala mostró propiedades psicométricas aceptables sugiriendo que es un instrumento útil para medir la percepción de los estudiantes sobre su participación en cursos de histología en formato e-learning. Los factores identificados mediante la validación del instrumento entregan información relevante para que los profesores y curriculistas desarrollen e implementen diferentes formas de estimular la participación de los estudiantes en cursos de histología e- learning y así apoyar el aprendizaje en formato online.

Virtual Microscopy as a Learning Tool in Brazilian Medical Education.

Virtual microscopy (VM) is a widely used teaching method in Medical Education in many developed countries. In Brazil, however, this is not the case for most medical schools, considering Brazilian social inequality and uneven access to technology. Recently, the Covid-19 pandemic has also challenged Universities to seek and make a transition toward more effective methods of full-time online education. Thus, the main goal of this work was to verify student's perception and academic performance, assessed upon VM implementation in a Brazilian Medical School. Ribeirao Preto Medical School students answered a 26-question survey with regards to optical microscopy (OM) and VM. Academic performance was compared between participants that were (year of 2019) or were not (year of 2015) exposed to VM. Taken the results together, subjective impressions such as handling, suitability, learning effectiveness, and pleasure using the tools, have shown a higher score for virtual microscopy (median = 29), when compared to optical microscopy (median = 24) with a P-value < 0.001 by Wilcoxon rank test, upon measurement using an ordinal scale. Regarding academic performance, no statistically significant differences were found between groups (P-value = 0.38, Cohen's d = 0.19). Therefore, VM proved to be adequate to the Brazilian medical education in light of Brazilian social contexts and Covid-19 pandemic.

Assessment of cardiac tumors by 18F-FDG PET/CT imaging: Histological correlation and clinical outcomes.

BACKGROUND: To evaluate the diagnostic value of 18F-FDG PET/CT in distinguishing benign versus malignant cardiac tumors as well as to assess its prognostic value. METHODS: We analyzed 38 patients with cardiac tumors who underwent 18F-FDG PET/CT and followed for median 8.5 ± 12.5 months. SUVmax and TBRmax (maximum tumor-to-background ratio) by receiver-operating characteristic (ROC) curve analysis were used to obtain threshold for the diagnosis of malignancy as defined by histology (n = 38). Survival was assessed and correlated with the dignity of the lesions and PET parameters. RESULTS: Optimal cut-off values indicating malignancy were as follows: SUVmax = 3.44, with 100% sensitivity and 92.9% specificity, and TBRmax = 1.55, with 95.8% sensitivity and 92.9% specificity. A significant difference of 18F-FDG uptake was observed between primary benign (n = 14, SUVmax = 2.35 ± 1.31, TBRmax = 1.05 ± 0.50) compared to primary malignant cardiac tumors (n = 11, SUVmax = 8.90 ± 4.23, TBRmax = 3.82 ± 1.44) as well as cardiac metastases and lymphoma (n = 13, SUVmax = 14.37 ± 8.05, TBRmax = 6.19 ±  3.38) (all P < .001). Survival rate was significantly lower in patients with malignant as compared to benign cardiac tumors (P < .05). Regression analysis revealed that the lesion dignity determined by the cut-off value of SUVmax was an independent predictor for death in patients with cardiac tumors (P < .05). CONCLUSION: 18F-FDG uptake in cardiac tumors can differentiate between benign and malignant cardiac tumors and predicts survival.

Evaluación del desempeño de los docentes de la asignatura Histología y Embriología / Assessment of the teacher's performance in the subject Histology and Embryology

Introducción: El éxito académico de la educación universitaria depende en gran medida de la calidad del desempeño de sus docentes. Para lograr un buen desempeño docente se requiere una formación profesional especializada y sistemática. Objetivo: Evaluar el desempeño del docente desde la percepción de los estudiantes. Métodos: El instrumento utilizado fue el cuestionario de opinión del estudiante sobre la docencia, compuesto por 40 reactivos, repartidos en nueve dimensiones. Se evaluaron 160 cuestionarios, donde los análisis estadísticos permitieron la obtención de porcentajes, medidas de tendencia central y de variabilidad, comparación de muestras y de análisis factorial, los análisis estadísticos se llevaron a cabo mediante el programa SPSS, versión 21.Resultados: Se presentó los resultados de la aplicación del Cuestionario de Opinión del Estudiante sobre la Docencia, en la asignatura Histología y Embriología de la Escuela de Medicina de la Facultad de Ciencias de la Salud, Universidad de Carabobo. Conclusiones: Con los datos obtenidos tenemos que la asignatura Histología y Embriología presenta un cuerpo docente que exhibe un alto desempeño en sus actividades relacionadas con el proceso de enseñanza-prendizaje(AU)

Introduction: Academic success in university education largely depends on the quality of the teacher's performance. To achieve good teaching performance specialized and systematic professional training is required. Objective: To evaluate the teacher's performance based on the student's perception. Methods: The instrument used was the questionnaire of the student's opinion about teaching, made up by 40 items, divided into nine dimensions. A total of 160 questionnaires were evaluated, in which statistical analysis allowed obtaining percentages, measures of central tendency and variability, comparison of samples and factorial analysis. The statistical analyzes were carried out through the SPSS program, version 21. Results: The results of the application of the Student's Opinion Questionnaire on Teaching were presented in the subject Histology and Embryology of the School of Medicine of the Health Sciences School at University of Carabobo. Conclusions: With the obtained data, we concluded that the subject Histology and Embryology presents a faculty that shows high performance in their activities related to the teaching-learning process(AU)

Cost Analysis of Sending Routine Pathology Specimens following Total Joint Arthroplasty in the Age of Bundled Payments.

Bundled payment plans are being developed as a means to curb healthcare spending. Routine histology following total hip arthroplasties (THA) and total knee arthroplasties (TKA) is standard practice at many institutions. Recently, the value of this practice has been questioned as histologic diagnoses in THA and TKA rarely differ from the clinical diagnoses. The goal of this study is to identify discrepant and discordant diagnoses following THA and TKA at an academic medical center and to calculate the cost-saving potential in the setting of a bundled payment plan. A retrospective chart review was conducted on 1,213 primary THA and TKA performed by two orthopaedic surgeons from 2012 to 2014. The clinical and histologic diagnoses were compared and classified as concordant, discrepant, or discordant. Cost information was obtained from the institutional billing office. One thousand one hundred and sixty-six THA and TKA were analyzed in the final cohort. Nineteen (1.6%) diagnoses were classified as discrepant while none were discordant. The cost of histologic examination per specimen was estimated to be $48.56. The total cost of all arthroplasties was $14,999,512.46, of which histologic examination made up 0.31% of the total cost. The results of this study corroborate the results of previous studies and support the proposition that routine histologic examination is not cost-effective. The cost incurred to perform histologic examination will become a cost deduction from future bundled payments. The practice of sending routine histologic specimens following TJA should be decided upon by the operating orthopaedic surgeon.

Assessment of local reaction to vaccines in live piglets with magnetic resonance imaging compared to histopathology.

The safety of veterinary vaccines is assessed in clinical trials in Europe. The assessment of the local tissue reaction to vaccination by magnetic resonance imaging (MRI) could reduce the number of animals needed because repeated examinations can be performed in the same animal over time. The present study compared the evaluation of local tissue reactions to vaccination using MRI in live pigs with histopathology of porcine tissue, the current gold standard in regulatory safety testing. Eight piglets each were administered one of two commercial vaccines into marked injection sites. All animals were sedated and scanned repeatedly by MRI using a contrast agent up to day 29 after vaccination. On day 29, the animals were euthanized and underwent a pathological examination. The MRI results were compared with the pathomorphological findings at the injection site by regression analysis. The MR images and the pathological examinations yielded matching results concerning the sizes of the affected tissue volumes or areas. The use of MRI for regulatory safety testing can reduce the number of animals needed to 8 per examination group. The volume of a local reaction and its progression over time can be evaluated and documented. If persistent lesions develop a final pathomorphological examination is needed to identify the kind and local distribution of the reaction.

The Mohs histotechnician: a review of training and practice within 29 centres in the UK.

BACKGROUND: Although various assessments pertaining to the surgical aspect of Mohs micrographic surgery (MMS) have been performed, the pivotal role played by the MMS histotechnician (MH) has not previously been addressed in the UK. AIM: To undertake a review of the training and practice of MHs in all centres performing MMS within the National Health Service (NHS) in the UK. METHODS: NHS dermatology departments performing MMS in the UK were identified and contacted by telephone between November 2011 and January 2012. MMS practice data pertaining to the role of the MH in tissue processing was collected by speaking directly to a histotechnician in each department. RESULTS: In total, 29 centres were identified. The number of MHs at each centre varied from 1 to 13 (median 3). All MHs had undergraduate degrees in biomedical science. Most (85%) MHs worked full-time under the directorate of their local pathology department. In 19 centres (66%), the Mohs surgeon reviewed the slides, and in the remaining 10 centres (34%), a consultant histopathologist reviewed the slides, either alone or in partnership with the Mohs surgeon. There was significant variation in tissue handling and processing techniques across the centres. All centres used MMS to treat primarily high-risk basal cell carcinomas, with over half (55%) also treating squamous cell carcinomas. MHs from all centres had learned about the specifics of MMS tissue processing 'on the job', with a minority having received formal training by attending a larger MMS centre or an MMS course. CONCLUSIONS: Significant variation in MMS tissue-processing techniques exists across the UK. A standard of practice should perhaps be considered, as this has risk-management, quality-control and possible medicolegal implications.

Comparative histomorphological assessment of the testes of two Clarias species from the Okavango Delta Panhandle, Botswana.

The testes of two Clarias species from the Okavango Delta Panhandle were histomorphologically assessed for differences in structure mainly because the testes varied externally in colour, with Clarias ngamensis having black testes while those of Clarias gariepinus were off-white. Although a detailed histological description of normal testes in C. gariepinus has been compiled based on laboratory experimentation, there is limited histomorphological field data available on both species which could be used as reference material in the histology and histomorphology assessment of gonads both in the laboratory and field experiments. In August 2006 and 2007 fifteen fish per species of C. ngamensis and C. gariepinus were collected from the Shakawe Panhandle in the Okavango Delta. Testicular samples excised from the fish were fixed in 10% neutral buffered formalin and later transported to the University of Johannesburg where laboratory analyses using standard histological procedures were conducted. Microscopic assessments were used to describe the testicular morphology and the reproductive developmental stages. Haematoxylin and Eosin (H&E), Periodic Acid Schiff (PAS), Perl's Prussian Blue and Gordon and Sweets Silver Stain Solution were used to enhance finer cellular detail and the morphology of various structures present in the catfish testes. Results emanating from this study (a) form a histomorphological baseline set of data from an undisturbed wetland system for comparison between normal morphology and anomalies within the catfish species, (b) contribute to the limited database of the normal histomorphology of gonads in Southern African freshwater fish species and (c) expand the academic knowledge and skills required for the conservation of wetland ecosystems in Southern Africa.

Virtual microscopy-The future of teaching histology in the medical curriculum?

Conventional continuing education in microscopic anatomy, histopathology, hematology and microbiology has hitherto been carried out using numerous sets of sectioned tissue specimens in a microscopy laboratory. In comparison, after digitalization of the sections it would be possible to access teaching specimens via virtual microscopy and the internet at any time and place. This would make it possible to put innumerable new learning scenarios into practice. The present article elucidates the advantages of virtual microscopy in histology instruction and presents a concept of how virtual microscopy could be introduced into the teaching of microscopic anatomy in several steps. Initially, the presently existing microscopic teaching specimens would be digitalized and made available on-line without restriction. In a second step, instruction would be shifted to an emphasis on virtual microscopy, utilizing all of the advantages offered by the technique. In a third step, the microscopic contents could be networked with other anatomical, radiological and clinical content on-line, thus opening new learning perspectives for students of human and dental medicine as well as those of medically related courses of study. The advantages and disadvantages of such a concept as well as some possibly arising consequences are discussed in the following.

Avaliação estrutural, estereológica e biomecânica do efeito da aplicação do ultrassom no reparo da lesão lacerativa experimental do gastrocnêmio de rato / Biomechanical, stereological and structural assessment of the ultrasound effect on the repair of muscle injury in rats

O objetivo deste estudo foi avaliar os efeitos do ultrassom pulsado (USp) no reparo muscular em um modelo experimental de lesão lacerativa do músculo gastrocnêmio medial em ratos Wistar. Vinte ratos foram tratados diariamente com USp (50%), 1MHz, 0,57W/cm² de intensidade por 5 min. formando os grupos tratados (GT), e 20 animais constituíram os grupos controle (CG). A análise histológica, morfométrica (usando o método estereológico) e biomecânica (teste de tensão) foi realizada aos 4, 7, 14 e 24 dias após a lesão. As lesões apresentaram um padrão de reparo similar tanto nos GT como nos GC. Os volumes absolutos da lesão (VL) e das zonas central e de regeneração (VZC e VZR) diminuíram progressivamente ao longo do processo de reparo tanto nos GT como nos GC. No GT, o VL diminuiu significativamente em todos os dias experimentais, sendo que VZC uma diminuição significante aos 4 e 7 dias pós-lesão e o VZR aos 14 dias pós-lesão. A fração de volume de vasos sanguíneos e a fração de superfície de vasos sanguíneos foi maior nos GT aos 4 e 7 dias pós-lesão em relação aos respectivos controles. Apesar de haver uma tendência a um maior volume absoluto de vasos sanguíneos nos GT, a análise estatística mostrou que existe uma maior volume de vasos somente aos 4 dias pós-lesão. Não houve diferença significante na área de superfície total de vasos sanguíneos na lesão quando se comparam os grupos entre si. Houve um aumento significante na fração de volume de fibras de colágeno na lesão nos GT aos 4,7 e 14 dias pós-lesão. Houve um aumento significante na tensão máxima e na rigidez nos GT aos 4 e 24 dias após a lesão. Não houve diferença significante na deformação relativa entre GC e GT. Os resultados sugerem que o USp otimiza a fase inflamatória e estimula as fases proliferativa e de remodelamento, promovendo uma diminuição mais acentuada no volume da lesão, estimulando a angiogênese, assim como, a deposição e a organização do colágeno fibrilar. Os achados histológicos...

The aim of this study was to evaluate the effect of the pulsed ultrasound therapy (PUT) in stimulating muscle repair in an experimental model of lacerative gastrocnemius medialis muscle lesion in 40 Wistar rats. Twenty rats were treated (TG) daily with 1MHz pulsed ultrasound (50%) at 0.57W/cm² for 5 min, and 20 were control animals (CG). Muscle samples were harvested up on postoperative days 4, 7, 14 and 24 for stereological, histological, and biomechanical analyses. The lesions presented similar repair pattern in both TG and CG. The lesion volume (VL) and the central and regenerative zones volumes (VCZ and VRZ) had a progressive deacrease through the post lesion period both in the TG and CG. The VL decrease was significantly greater in the TG in all experimental days, the VCZ decrease was significant in the TG at 4 and 7 days post lesion, and the VRZ decrease was significant at 14 days post lesion in the TG. Statistically significant increase was found in the blood vessels volume fraction and in the surface fraction of blood vessels in the TG at 4 and 7 days post lesion compared to respective CG. Although there was a tendency to have a greater blood vessels absolute volume within lesion in the TG, the statistical analysis showed that it was only larger at 4 days after surgery in US treated group. No statistically significant increase was found in the surface total area within lesion in all experimental days between CG and TG. There was a significant increase in the volume fraction of fibrilar collagen within the lesion in the TG at 4, 7 and 14 days post lesion. The biomechanical data showed a significant increase in the maximal stress and stiffness in the TG at 4 and 24 days after lesion, although there was a progressive increase of these variables both in the CG and TG. There was no significant difference in the maximal elongation, between CG and TG. Our data suggest that the PUT acts as an inflammatory optimizer and stimulates the proliferative and...

Utilização de enxerto de tecido conjuntivo no tratamento de lesões periodontais infra-ósseas proximais: Avaliação clínica, radiográfica e histomorfométrica / Use of connective tissue graft in the treatment of infra-bone proximal periodontal lesions: clinical, radiographic and histomorphometric assessment

Este trabalho tem como objetivo avaliar a eficácia do uso de enxerto de tecido conjuntivo comparativamente a regeneração tecidual guiada, no tratamento de defeitos infra-ósseos. Para tanto, foram realizados dois estudos. No Estudo 1, defeitos infra-ósseos bilaterais foram criados na mesial dos caninos superiores de cinco cães, que após o período de cronificação (seis semanas), foram raspados e alisados. Duas semanas depois, as lesões foram aleatoriamente tratadas com enxerto de tecido conjuntivo (grupo ETC) ou membrana reabsorvível (grupo RTG). Dados clínicos foram colhidos previamente à cirurgia e 12 semanas após. Neste último período, os animais foram mortos, e procedeu-se à confecção das lâminas histológicas. Na análise dos resultados não foram detectadas diferenças estatisticamente significantes entre os grupos, porém, em ambos os grupos contatou-se redução da profundidade de sondagem (p=0,032). A análise histológica revelou menor extensão de novo cemento (p=0,001), de novo osso (p=0,003), e da extensão total de tecido conjuntivo (p=0,013) no grupo ETC em comparação com o RTG. Para o Estudo 2 foram selecionados 12 pacientes com defeitos infra-ósseos bilaterais, de duas ou três paredes, que após tratamento básico periodontal foram indicados para terapia cirúrgica no modelo de boca-dividida. Aleatoriamente, os defeitos periodontais foram designados a fazer parte do grupo ETC ou RTG. Avaliações clínicas e tomadas radiográficas foram realizadas previamente à cirurgia, seis e 12 meses pós-operatórios. Diferenças estatisticamente significantes não foram detectadas entre os grupos, porém, em ambos observou-se redução da PS (p=0,000), e aumento de recessão (p=0,002). Apenas o grupo RTG apresentou ganho de inserção (p=0,004). Dentro dos limites do presente estudo, pode-se concluir que o enxerto de tecido conjuntivo não foi eficiente no tratamento de defeitos periodontais infra-ósseos de duas ou três paredes.

[Neurocience in the Junta para Ampliación de Estudios]. / Neurosciencias en la Junta para Ampliación de Estudios.

The development of the Neurociencias in the Spain at the first third of the 20th century had a strong histological and pathological component. The work of Santiago Ramon and Cajal and Luis Simarro was continued by some excellent disciples: Nicolas Achúcarro, Gonzalo Rodriguez Lafora, Fernando de Castro, etc. Some of them had to make compatible diverse occupations, even the professional exercise of psychiatry, before obtaining a modest - but stable - position of investigation. In spite of some misalignments in the institutional development of the centers and the personal biographical ups and downs, the Junta para Ampliación de Estudios was the great institution that fomented the international formation of the investigators and equipped to them with the means to develop its work.

Transmissible spongiform encephalopathies: assessment of exposure risk in the histological working environment using GC-MS detection of fatty acids as marker for central nervous tissues.

To elucidate the risk of occupational exposure to the agent of transmissible spongiform encephalopathies (TSE) in the histological working environment, we assessed the principal suitability of three analytical methods for the detection of tissues of the central nervous system (CNT). We tested a neuron-specific enolase (NSE) Western blot, a glial fibrillary acidic protein (GFAP) ELISA and the GC-MS detection of some CNT typical fatty acids (FAs): omega9-tetracosenic acid, omega7-tetracosenic acid, lignoceric acid, and cerebronic acid. Histological sample processing (formalin fixation, dehydration, paraffin embedding) affected both of the immunochemical approaches considerably. The NSE Western blot produced negative results without exception. The results for the GFAP ELISA were better but still far too insensitive. Thus, both methods were judged to be unsuitable in their present form without major analytical adjustment. GC-MS sensitivity remained unaffected by the formalin fixation process. Sensitivity was reduced in the course of the final dehydration step using xylene in the histological sample processing. However, this reduction was found to be rather moderate (range 42-59%) when compared to the immunochemical methods. Overall, we judged GC-MS to be a promising analytical approach for the assessment of a potential TSE exposure risk via airborne CNT particles in the histological working environment. All the FAs we tested showed very low but detectable baseline contents. Thus, cut-off values must be used in the present GC-MS approach. The most suitable FA turned out to be omega9-tetracosenic acid due to the greatest difference between its content in histological CNT samples and the respective cut-off value (689:1). Preliminary results by GC-MS monitoring of CNT via omega9-tetracosenic acid (and other FAs) on filters of routinely used vacuum cleaners and on filters after air sampling indicate that the airborne CNT/TSE exposure risk in the histological laboratory is minor if existing at all. However, further in depth studies will have to validate our preliminary findings and assess these results in the light of possible future data on human oral and/or pulmonary TSE susceptibility.

Collagen and picrosirius red staining: a polarized light assessment of fibrillar hue and spatial distribution

Collagen plays a vital role in maintaining structural integrity and in determining tissue function. Therefore, methods to detect, quantify, and analyze collagen are valuable. Nevertheless, stains historically employed to detect collagen have disadvantages, principally a poor specificity for thin fibers. Conversely, picrosirius red, which has the capability to detect thin fibers, although frequently used, is seldom exploited to the fullest extent. Our goal was, using picrosirius red staining, circularly polarized light, and image-analysis software, not only to identify fibers and quantify collagen content, but also to assess fiber hue and the spatial distribution of the different colors. To assess collagen content, we used a subtraction technique to remove interstitial space and non-collagen elements from images of skin wounds, myocardial scars, and arterial tissue. The hue component of the resulting image was obtained, and the number of red, orange, yellow, and green (the colors of collagen fibers in order of decreasing thickness) pixels calculated. Finally, we assessed the spatial distribution of individual colors by the application of color threshold filters. Skin wound analysis demonstrated good inter-observer agreement for collagen content and fiber color. In myocardial scars, collagen content increased from 1 (61 por cento) to 5 weeks (95 por cento) after injury. The proportion of green (thin) fibers decreased (43 to 4 por cento), while the proportion of orange (thick) fibers increased (13 to 65 por cento). Color threshold application revealed regional variation in fiber color within subintimal arterial lesions. These methods increase the amount of structural information obtained from picrosirius red-stained sections.

Are external quality assurance (EQA) slide schemes a valid tool for the performance assessment of histopathologists?

Quality assurance plays a vital role in the healthcare profession and histopathologists play a central role in the diagnosis and treatment of disease. In the past these specialists have worked in isolation and quality assurance of their work has been difficult. In recent years this has changed with the introduction of External Quality Assurance slide schemes. This paper discusses how these schemes have evolved, the problems of standard setting and their validity as a measure of pathologists performance.

[The assessment of structure-function interrelationship from the standpoint of functional systems]. / Otsenka vzaimootnoshenii struktury i funktsii c pozitsii funktsional'nykh sisem.

One of the major methodological problems of morphology--the correlation of "structure" and "function" categories in normal anatomy and histology--is discussed. The issues of mobility of concepts concerning organization of functional systems, differon tissue organization, tissue classification including the special place of extraembryonic organs, are examined. The organizational matters associated with the introduction of a new speciality 03.00.25--histology, cytology, cell biology--and with the necessity of revision of the program of qualifying examination in philosophy for the candidate's degree in the field of histology, are discussed.