Expression of certain proteins in the subfornical organ and cerebrospinal fluid of spontaneously hypertensive rats.

The objective of this study was to analyze the proteins in the cerebrospinal fluid of spontaneously hypertensive rats and to study their possible role in the relationship between hydrocephalus, arterial hypertension and variations in the subfornical organ. Brains and cerebrospinal fluid from control Wistar-Kyoto rats and spontaneously hypertensive rats sacrificed with chloral hydrate were used. Cerebrospinal fluid and extract of subfornical organ were processed by protein electrophoresis. Antisera against protein bands of 141, 117 and 48 kDa and Concanavalin A were used for immunohistochemical and western blot study of the subfornical organ, adjacent circumventricular structures and cerebrospinal fluid. Ventricular dilation in the spontaneously hypertensive rats and the presence of quite a lot of protein bands in the cerebrospinal fluid of the hypertensive rats, which were either not observed or scarcely present in the cerebrospinal fluid of the Wistar-Kyoto rats, were confirmed. The subfornical organ, third ventricle ependyma and choroideus plexus showed immunoreactive material for antibodies against 141kDa, 117 and 48 kDa proteins band (anti-B1, anti-B2 and anti-B3). The larger amount of the immunoreactive material was found in the subfornical organ of the spontaneously hypertensive rat. Our results and the alterations observed by other authors in the subfornical organ in hydrocephalic and hypertensive rats support the possibility that this circumventricular organ, some proteins of the cerebrospinal fluid and ventricular dilation could be connected with the physiopathology of this type of hypertension.

[Study of the introduction of the European Credit Transfer System (ECTS) in pediatrics and modification of the teaching methodology]. / Estudio sobre la introducción del Sistema de Transferencia de Créditos Europeo en Pediatría y modificaciones de la metodología docente.

INTRODUCTION: Spanish medical faculties have initiated the new curriculum reform process within the framework of the European Higher Education Area and are required to incorporate the European Credit Transfer System (ECTS) to new syllabi before 2010. OBJECTIVES: To test the introduction of the ECTS in pediatrics and modify the teaching methodology. STUDY DESIGN: The theoretical and practical programs were adapted; academic objectives and a student evaluation system were established. Students were surveyed on starting the second term of the 2004-05 academic year before the theory examination and again on terminating the academic year: a 5-point Likert-type scale was used for responses. Priorities for generic and specific competencies selected by students were compared with those selected by the National Deans Conference (NDC). The results were analyzed using non-parametric tests. RESULTS: Fifteen credits became 11 ECTS, with 297 student working hours. The theory program was reduced from 80 to 52 lessons. The students prepared 14 tutor-supervised case presentations. The teaching staff considered that learning of theory was similar to previous years (66 %) and that practical learning improved (73.3 %). The students thought the program should continue (73.2 %) but 98.8 % considered the workload excessive. The students believed that their practical training and their ability to prepare and make case presentations significantly improved during the semester. Academic performance was significantly higher than that in students of the previous year. Students agreed with NDC priorities for 9/9 general and 4/17 specific competencies. Estimation of workload by students was significantly higher than that by staff, and 73.3 % of the students believed that workload should be reduced and the examination system improved. CONCLUSIONS: Introducing the ECTS improved academic performance, practical training, and self-directed learning. The project was satisfactory for staff and students. Student workload was underestimated.

Estudio sobre la introducción del Sistema de Transferencia de Créditos Europeo en Pediatría y modificaciones de la metodología docente / Study of the introduction of the european credit transfer system (ECTS) in pediatrics and modification of the teaching methodology

Introducción Las Facultades Médicas españolas han comenzado el nuevo proceso de reforma curricular en el marco del proceso de implantación del Espacio Europeo de Educación Superior y deben incorporar el Sistema de Transferencia de Créditos Europeo (ECTS) a los nuevos planes del estudio antes de 2010. Objetivos El objetivo del trabajo fue experimentar la introducción de los créditos ECTS en la asignatura de Pediatría y modificar la metodología docente. Diseño del estudio Adaptación del programa teórico y práctico, estableciendo unos objetivos docentes y un sistema de evaluación. Se realizaron encuestas a los alumnos al inicio del segundo cuatrimestre del curso 2004-2005, antes de realizar el examen teórico de la asignatura y al finalizar el curso académico, utilizando para las respuestas una escala de tipo Likert con 5 grados. Se comparó la priorización de las competencias genéricas y específicas de los alumnos con la de los profesionales médicos en la encuesta de la Conferencia Nacional de Decanos (CND). Para el análisis de los resultados se aplicaron pruebas no paramétricas. Resultados Los 15 créditos actuales se transformaron en 11 ECTS, con 297 h de trabajo para los alumnos. Se redujo el programa teórico de 80 a 52 lecciones. Los alumnos prepararon y presentaron 14 casos clínicos, bajo la supervisión de sus tutores. Los profesores consideraron que el aprendizaje teórico había sido similar al de cursos anteriores (66,6 %) y había sido mejor el práctico (73,3 %). Los alumnos opinaron que el proyecto debía continuar (73,2 %), pero el 98,8 % consideraron que la carga de trabajo había sido excesiva. Los alumnos apreciaron de forma estadísticamente significativa que mejoró la docencia práctica y su capacidad para preparar y presentar casos clínicos. El rendimiento académico de los alumnos fue significativamente mejor que el de los alumnos del curso anterior. Los estudiantes estuvieron de acuerdo con la prioridad de competencias de la CND para 9/9 de las generales y 4/17 de las específicas. La estimación de horas de trabajo de los alumnos fue mayor por los alumnos que por los profesores. El 73,3 % de los alumnos contestaron que el proyecto debía mejorarse, reduciendo la carga de trabajo de los alumnos y mejorando el sistema de evaluación. Conclusiones La introducción de los ECTS mejoró el rendimiento académico, la formación práctica y el autoaprendizaje de los alumnos. La experiencia fue satisfactoria para profesores y alumnos. La estimación de la carga de trabajo de los alumnos fue subestimada

Introduction Spanish medical faculties have initiated the new curriculum reform process within the framework of the European Higher Education Area and are required to incorporate the European Credit Transfer System (ECTS) to new syllabi before 2010. Objectives To test the introduction of the ECTS in pediatrics and modify the teaching methodology. Study design The theoretical and practical programs were adapted; academic objectives and a student evaluation system were established. Students were surveyed on starting the second term of the 2004-05 academic year before the theory examination and again on terminating the academic year: a 5-point Likert-type scale was used for responses. Priorities for generic and specific competencies selected by students were compared with those selected by the National Deans Conference (NDC). The results were analyzed using non-parametric tests. Results Fifteen credits became 11 ECTS, with 297 student working hours. The theory program was reduced from 80 to 52 lessons. The students prepared 14 tutor-supervised case presentations. The teaching staff considered that learning of theory was similar to previous years (66 %) and that practical learning improved (73.3 %). The students thought the program should continue (73.2 %) but 98.8 % considered the workload excessive. The students believed that their practical training and their ability to prepare and make case presentations significantly improved during the semester. Academic performance was significantly higher than that in students of the previous year. Students agreed with NDC priorities for 9/9 general and 4/17 specific competencies. Estimation of workload by students was significantly higher than that by staff, and 73.3 % of the students believed that workload should be reduced and the examination system improved. Conclusions Introducing the ECTS improved academic performance, practical training, and self-directed learning. The project was satisfactory for staff and students. Student workload was underestimated

Alterations of the cerebrospinal fluid proteins and subcommissural organ secretion in the arterial hypertension and ventricular dilatation. A study in SHR rats.

The aim of this work was to analyze the proteins in the cerebrospinal fluid (CSF) of spontaneously hypertensive rats, to study their possible role in the relationship between hydrocephalus, arterial hypertension and alterations in the subcommissural organ. Brains from control Wistar-Kyoto rats (WKY) and spontaneously hypertensive rats (SHR) sacrificed with chloral hydrate were used. Antiserums against some cerebrospinal fluid protein bands and Reissner's fiber (RF) were used for immunohistochemical study of the SCO. Ventricular dilation was observed in the lateral and third ventricle of the SHR. Third ventricle ependyma showed immunoreactive material (IRM) for antibody against 141 kDa protein band anti-B1 and 117 protein band anti-B2 and the SCO of the SHR showed a decrease of the IRM when compared with WKY rats. An alteration in the expression of anti-RF was found to compare the SCO of the WKY and SHR groups. Our results demonstrate that hydrocephalus and hypertension are interconnected in this kind of rat which produce alterations in SCO secretions and some proteins of the CSF.

Postnatal development of the secretory activity of the goat subcommissural organ. A Reissner's fibre and angiotensin II immunohistochemical study.

Subcommissural organ (SCO) secretory activity of the goat (variations of Capra hircus, that live in arid conditions) was examined during the postnatal development, using specific antibodies against the Reissner's fibre (AFRU) and angiotensin II (AAGII). The SCO was strongly stained with the anti-glycoproteins that form the Reissner's fibre and lightly marked with the anti-angiotensin II. The AFRU-immunoreactivity (ir) was found in the ependymal and hypendymal cells and in the ventricular and peripheral secretory routes of the goat SCO. The amount AFRU increases at 6 months and decreases at adult age. In contrast, the anti-angiotensin II-ir was mainly found in the adult age, not being practically observed at one postnatal month. The AAGII-ir was mainly found in ependymal cells in which AFRU-ir was downregulated. In addition, we detected the presence of double immunostained for AFRU and AAGII in ependymocytes of the pre-commissural and subcommissural parts. In conclusion the present results may suggest a functional interrelation between AAGII and the secretory activity of the SCO of this kind of goat.

Effect of the arterial hypertension and captopril treatment on the angiotensin II content in the subfornical organ. A study in SHR rats.

We studied the effects of spontaneous high blood pressure and the captopril treatment on the subfornical organ (SFO) of rats. The brains of control Wistar-Kyoto rats (WKY), WKY rats treated with captopril (WKY-T), spontaneously hypertensive rats (SHR) and SHR rats treated with captopril (SHR-T) were processed immunohistochemically using anti-angiotensin II as primary antibody. Immunorective material (IRM) for angiotensin II was observed in a group of neurons and some cells of the ependymal layer of the SFO in WKY rats. The angiotensin II immunoreactive (AGII-ir) in the SHR rats was decreased, showing positive reaction only in a few neurons, while captopril treatment induced an increase in immunoreactive material in hypertensive rats, but contrarily, the expression of AGII-ir in the WKY-T group was scarce. The variations of the angiotensin II observed in the SFO could be owing to an interaction between the hypertension and its captopril treatment.

Ontogenic development of the human subcommissural organ

The structure of the human subcommissuralorgan during its ontogenic development in 24human embryos and foetuses ranging from 6 to40 weeks of gestation (WG), and three adulthuman brains from 27-, 65- and 70-year old subjectswas investigated using both qualitative andquantitative methods. Concurrently, the appearanceof the subcommissural organ, pineal glandand mesocoelic recess was determined by studyingtheir structure, length and volume. Thehuman SCO appears at the beginning of 8th WG,which confirms previous results; the completematuration of the SCO occurs at the 15th WG andthe following three parts can be distinguished:the precommissural part, located in the rostralzone of the posterior commissure (PC) andextending to the pineal recess; the subcommissuralpart, located under the PC, and the retrocommissuralpart, located in the caudal zone ofthe PC, in the mesocoelic recess and at thebeginning of the Sylvian aqueduct. The reductionin size of the SCO begins after the 17th WGand this decrease in size begins in the precommissural,continues in the subcommissural, andfinishes in the retrocommissural part. The regressionand atrophies of the SCO begin after birth,and the SCO disappears completely after the ageof 30. The mesocoelic recess starts to form at thebeginning of the 10th WG, and is completely formedby the 14th WG and this is where the retrocommissuralpart of the SCO is located. In the 40th WG the regression of the mesocoelic recessbegins and this takes place at the same time asthe regression of the SCO. A parallel developmentbetween the SCO and the pineal wasfound. Thus, we observed the first appearance ofthe pineal recess in the 7-8th WG; during the 10thWG a compact mass of cells appeared in the rostralpart of pineal recess and by the 15th WG thepineal gland (PG) had acquired an almost definitiveaspect

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Connection between the arcuate nucleus and the posterior lobe of the hypophysis. An angiotensin II immunohistochemical study in rats

The aim of this study was to perform an immunohistochemical study of the, angiotensinergic pathway from the arcuate nucleus (AN) to the posterior lobe of the hypophysis (PLH) of 10-week-old matched normotensive Wistar Kyoto rats (WKY), using our own policlonal antibody raised in mice against Angiotensin II (mouseantiangiotensin II, MAAII). Cells and fibers in the rostroventral and dorsocaudal parts of the AN, the internal zone of the median eminence and PLH showed immunoreactive material for antiangiotensin II. Angiontensin II fibers originating in the anteroventral part of the AN, crossing median eminence (ME) and infundibular stem and arriving at the PLH were also observed (AU)

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Assessing the relative quality of anesthesiology and critical care medicine Internet mailing lists.

UNLABELLED: We studied the relative quality of a subset of anesthesiology and critical care medicine Internet mailing lists regarding the publishing capacity of their members to compare them with the major journals and conferences regarding these specialties. Using systematic searches on MEDLINE and according to the Science Citation Index 1995, we investigated the impact factor of mailing list subscribers, of the first authors of the selected articles, and of the first authors of published abstracts from conferences. We studied six mailing lists, seven journals, and four conferences. Journals and conferences showed a higher percentage of published authors and higher average impact factor among their first authors than the mailing lists did per subscriber. However, when only the subset of publishing authors from the three media was considered, no significant differences were found. We conclude that qualified authors may be found among the subscribers of Internet medical mailing lists on anesthesiology and critical care medicine. These professional discussion groups could complement peer-reviewed publications and conferences in professional information exchange and continuing medical education. IMPLICATIONS: Internet publishing is not governed by rules that assure certain basic quality standards. Methods for assessing these standards are needed. We compared discussion groups with medical journals and conferences on anesthesiology and critical care medicine by calculating the impact factor of their members and first authors, respectively. Our study shows that qualified authors may be found in all three media.

Alterations of the subcommissural organ in the hydrocephalic human fetal brain.

We have studied the subcommissural organ of two hydrocephalic brains, of 20 and 21 gestational weeks and of two normal brains, aged 19 and 23 gestational weeks. Both hydrocephalic cases presented a size reduction of the subcommissural organ compared to the normal cases; only in one case, there were also alterations of the morphological components of the subcommissural organ, suggesting different pathogenic relationships between hydrocephalus and dysplasia of the subcommissural organ.

[Treatment of life threatening asthma with isoflurane]. / Tratamiento del "Life threatening asthma" con isofluorane.

Three patients, one adult, one adolescent and one child, with previous history of asthma difficult to treat and frequent acute crisis, were hospitalized with clinical signs of Life Threatening Asthma (LTA) refractory to intensive treatment, including intubation and mechanical ventilation, being treated with and inhaled anesthetic: Isoflurane. All patients responded satisfactorily to such treatment at a concentration varying from 0.5 to 1.5% and none of them suffered adverse reactions to the medication. The immediate therapeutic effect and the absence of intensive care are factors that indicate the use of Isoflurane.

[Ganglio-thalamic encephalomalacia. Ultrasonic diagnosis]. / Encefalomalacia gangliotalámica. Diagnóstico sonográfico.

We have performed serial trans-fontanelle sonography on 69 newborns with perinatal asphyxia. Ten neonates presented high ultrasonic density in the thalamus and the basal ganglia. These images were preceded, in eight of them, by diffuse echoes for all of the CNS, corresponding to cerebral edema. The most significant clinical findings were convulsions and important depression of conscience level and muscular tone. Eight of ten newborns presented major abnormalities in the electroencephalogram (severe depression of background). Since its coexistence with other parenchymal lesions and poor neurologic development, we consider the ganglio-thalamic ultrasonic densities to be a sign of severe ischemic hypoxic cerebral damage.

[Extrinsic allergic alveolitis: apropos of a case in a child]. / Alveolitis alérgica extrínseca: a propósito de un caso en edad pediátrica.

We present a young male (12 years) with low grade fever, weight loose, anorexia and progressive dyspnea. The clinical, roentgenological and pulmonary function pictures are close with interstitial pneumonitis. The patient had a pigeon loft on his house, thus we tried confirmed the diagnosis of extrinsic allergic alveolitis: pigeon breeder's lung. We believed at any patient age the pigeon breeder's lung must be considered in the differential diagnosis of interstitial pneumonitis. A good anamnesis will avoid unnecessary complementary test.

[Cessation of breast feeding: mothers exposed to the above-mentioned risk]. / Supresión de la lactancia materna: madres expuestas a dicho riesgo.

We have investigated the incidence of breast-feeding and factors that concerns it, in 135 mothers who gave birth from January to July 1986 in our hospital. 97% of mothers began breast-feeding, but only 42% went on with it at third month of infant's life, and only 9.75% of them at sixth month. The most common reason for breast feeding failure is the "cry baby". The mother's age, the socioeconomic level, the mother-newborn bonding after delivery are related with lengthy breast feeding. In conclusion, the lower social levels are the target for the information in order to promote the breast-feeding.