Teambasert læring – en studentaktiviserende og lærerstyrt undervisningsform

Sammendrag Bakgrunn: Studentaktiviserende undervisning er viktig for å oppnå god læring. I teambasert læring (TBL) aktiviseres studentene individuelt, gruppevis og i plenum under ledelse av faglærer. TBL er i liten grad prøvd ut og evaluert i medisinsk utdanning i Norge. Vi ville derfor undersøke hvorvidt TBL kan være egnet som undervisningsform i grunnutdanningen av leger. Materiale og metode: Vi arrangerte TBL i generell patologi for andreårs medisinstudenter i 2013 og 2014. TBL-sesjonen varte i tre timer og inkluderte individuell og gruppevis oppvarmingstest, gruppearbeid, plenumsdiskusjon og oppsummering fra faglærer. Svarene på oppgavene ble samlet inn for å sammenlikne individuelle og gruppevise prestasjoner på testene. Studentene ble også bedt om å evaluere undervisningen. Resultater: Gruppenes prestasjoner var bedre enn eller like gode som 84 % (2013) og 72 % (2014) av de individuelle prestasjonene. TBL ble av studentene oppfattet som en engasjerende og lærerik undervisningsform som egner seg til oppsummering og som tilbakemelding på eget kunnskapsnivå. Til tross for at tidsbruken ble beskrevet som unødvendig lang, var studentene tydelige på at TBL burde integreres i medisinstudiet. Fortolkning: Vi anbefaler TBL som undervisningsform i grunnutdanningen i medisin

Gastric Carcinomas Localized to the Cardia

Objectives. Gastric adenocarcinomas localized to the cardia are increasing. Enterochromaffin-like (ECL) cells play a role in gastric carcinogenesis in hypergastrinemia, and the use of proton pump inhibitors (PPI) leading to hypergastrinemia has increased considerably during the last decades. We have examined cardia cancers for neuroendocrine and ECL cell differentiation. Methods. Thirty-two cardia cancers were examined by immunohistochemical labelling of chromogranin A (CgA), synaptophysin, serotonin, and histidine decarboxylase (HDC). Information about PPI use was collected from the patient records. Results. In 15 of 32 tumours, there were positive signs for one or several neuroendocrine markers. Five cases were CgA and serotonin positive; three of these carcinomas were also positive for HDC. Three patients were long-term users of PPI, and two of these were immunoreactive for neuroendocrine markers. Conclusions. A high proportion of cardia cancers expressed neuroendocrine markers, but only few patients with cardia cancers were using PPI

Correction: Relevance of TNBS-Colitis in Rats: A Methodological Study with Endoscopic, Histologic and Transcriptomic Characterization and Correlation to IBD.

Rectal instillation of trinitrobenzene sulphonic acid (TNBS) in ethanol is an established model for inflammatory bowel disease (IBD). We aimed to 1) set up a TNBS-colitis protocol resulting in an endoscopic and histologic picture resembling IBD, 2) study the correlation between endoscopic, histologic and gene expression alterations at different time points after colitis induction, and 3) compare rat and human IBD mucosal transcriptomic data to evaluate whether TNBS-colitis is an appropriate model of IBD.Five female Sprague Daley rats received TNBS diluted in 50% ethanol (18 mg/0.6 ml) rectally. The rats underwent colonoscopy with biopsy at different time points. RNA was extracted from rat biopsies and microarray was performed. PCR and in situ hybridization (ISH) were done for validation of microarray results. Rat microarray profiles were compared to human IBD expression profiles (25 ulcerative colitis Endoscopic score demonstrated mild to moderate colitis after three and seven days, but declined after twelve days. Histologic changes corresponded with the endoscopic appearance. Over-represented Gene Ontology Biological Processes included: Cell Adhesion, Immune Response, Lipid Metabolic Process, and Tissue Regeneration. IL-1α, IL-1β, TLR2, TLR4, PRNP were all significantly up-regulated, while PPARγ was significantly down-regulated. Among genes with highest fold change (FC) were SPINK4, LBP, ADA, RETNLB and IL-1α. The highest concordance in differential expression between TNBS and IBD transcriptomes was three days after colitis induction. ISH and PCR results corresponded with the microarray data. The most concordantly expressed biologically relevant pathways included TNF signaling, Cell junction organization, and Interleukin-1 processing.Endoscopy with biopsies in TNBS-colitis is useful to follow temporal changes of inflammation visually and histologically, and to acquire tissue for gene expression analyses. TNBS-colitis is an appropriate model to study specific biological processes in IBD