The expression of tenascin-C and tenascin-W in human ossicles.

The ossicles of the middle ear (the malleus, incus and stapes) transmit forces resulting from vibrations of the tympanic membrane to the cochlea where they are coded as sound. Hearing loss can result from diseases such as rheumatoid arthritis (RA) that affect the joints between the ossicles or degenerative processes like otosclerosis that lead to ankylosis of the footplate of the stapes in the oval window of the cochlea. In this study, immunohistochemistry was used to determine if the extracellular matrix glycoproteins tenascin-C or tenascin-W are expressed in the incudomalleolar and incudostapedial joints of ossicles dissected from human cadavers. Tenascin-C, which is expressed during inflammatory conditions including RA, was seen in the articular cartilage of the incudomalleolar joints and the head of the stapes. Tenascin-W, in contrast, was enriched in the annular ligament that anchors the footplate of the stapes into the oval window of the cochlea.

Undergraduate coursework in anatomy as a predictor of performance: comparison between students taking a medical gross anatomy course of average length and a course shortened by curriculum reform.

The performance of students taking medical gross anatomy at the University of California at Davis during a 4-year period (1999-2002) was correlated with prior undergraduate anatomy coursework. Significant correlations were observed between class rank in medical anatomy and taking any undergraduate anatomy as well as the total number of undergraduate anatomy units (P<0.01). Taking human gross anatomy and an anatomy laboratory course were significantly correlated with medical anatomy class rank (P<0.01) as were grades in human anatomy, comparative vertebrate anatomy and anatomy laboratory courses (P<0.05). The medical anatomy course offered in 1999-2000 was 172 hr long, and the course offered in 2001-2002 was 135 hr long, with most of the difference made by decreasing lecture time while sparing the dissection laboratory. The reduction in course length was the consequence of a curriculum-wide cap in weekly contact hours. In the 172-hr medical anatomy course there were significant correlations between the students who took undergraduate anatomy and both class rank and the score on the final examination (P<0.01). These correlations did not exist for the 135-hr course. This may be explained by previous anatomy experiences helping students learn from lecture more than from dissection laboratory, as well as the extra study time available to students in the reformed medical curriculum. Pre-medical students and health science advisors need to consider that the benefits of taking anatomy as an undergraduate may be dependent on the configuration of a medical school's curriculum.

Medical gross anatomy as a predictor of performance on the USMLE Step 1.

Traditional predictors of medical school performance, such as Medical College Admission Test (MCAT) scores and grade point averages, are often used during the admissions process to help identify the prospective students who are most likely to complete the basic science portion of the curriculum successfully. Here we analyzed the admissions files and student records of 285 first-year medical students who matriculated at the University of California at Davis School of Medicine between 1999 and 2001 to determine if performance in medical gross anatomy is a similar, if not better, predictor of performance on the United States Medical Licensing Examination (USMLE) Step 1 than traditional predictors used by medical school admissions committees. Though MCAT scores and grade point averages were correlated with scores on the USMLE Step 1, only the score on the biological science section of the MCAT was significantly correlated with passing the licensing examination. In contrast, class rank in medical gross anatomy and the score on a gross anatomy comprehensive final examination were correlated both with scores on the USMLE Step 1 and passing the examination. Our results indicate that medical schools should consider performance in medical gross anatomy just as much, if not more, than traditional predictors of medical school performance when trying to identify students who may need more time or tutoring to pass the licensing examination.