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Gupta C, Shree N, Saruparia K, Saboo S, Kumari N, Shah G, Das S. Utility of pig head model as an oculoplastic wet lab surgical training tool. Orbit 2024:1-9. [PMID: 39023222 DOI: 10.1080/01676830.2024.2363217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/29/2024] [Indexed: 07/20/2024]
Abstract
PURPOSE To assess the utility of pig head model as an oculoplastic surgical training tool. METHODS Fresh pig head was availed for surgical workshop for entropion correction, eyelid margin repair, and evisceration with implant for oculoplastic surgery-naïve participants. Skill improvement, surgical understanding, and performance of the participants were evaluated both subjectively and objectively by trained oculoplastic surgeons. Subjective assessment was done by a standardized questionnaire based on Likert scale shared with the participants post training. Objective evaluation was done by the faculty based on a three-point scale and a competency-based surgical assessment rubric. RESULTS There were 18 surgery-naïve participants in the workshop which comprised ophthalmology residents and comprehensive ophthalmologists. About 88.88% of the participants were able to perform the lid margin and sub-tarsal dissection in entropion surgery. While performing lid tear repair, 94.44% were correctly able to identify the grey line and anterior and posterior lamellae. About 83.33% of the participants were able to place an implant in the scleral shell or intraconal space. About 83.33% of the participants noted that texture and tissue maneuvering were similar to the human eye while performing surgical steps. About 94.44% of the participants reported better understanding, development of skill and additional confidence after training. The median score on objective assessment was 3. The performance on real patients resulted in a median score of 4 for entropion correction. CONCLUSION Porcine orbital dissection is an available, affordable, and useful tool for oculoplastic surgical training. Training on porcine model can improve anatomical understanding, clinical judgement, and surgical efficiency in trainees.
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Affiliation(s)
- Chhavi Gupta
- Oculoplasty and Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Neha Shree
- Oculoplasty and Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Kshiti Saruparia
- Oculoplasty and Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Surbhi Saboo
- Oculoplasty and Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Namita Kumari
- Oculoplasty and Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Gaurav Shah
- Oculoplasty and Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Sima Das
- Oculoplasty and Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
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Liao J, Wright RR, Vora GK. The Decline of Basic Ophthalmology in General Medical Education: A Scoping Review and Recommended Potential Solutions. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241245635. [PMID: 38596233 PMCID: PMC11003344 DOI: 10.1177/23821205241245635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This literature review aims to explore research and conceptual pieces on the state of ophthalmology education and suggest potential ways to address current challenges. METHODS A search was conducted in PubMed, ERIC, Web of Science, and Google Scholar with combinations of the following search terms: "ophthalmology education," "undergraduate medical education," "medical student," "United States," and "Canada." Eliminating irrelevant articles yielded 47 articles. Three were excluded because of region and focus, leaving 44. After examining the citations, we generated an additional 22 texts for review, totaling 66 articles. RESULTS Four primary themes were identified: (1) challenges to ophthalmological education in the U.S. and Canada, (2) potential remedies for optimizing ophthalmology curriculum, (3) technology in ophthalmology education, and (4) innovative ophthalmology teaching approaches. Major challenges included the lack of a standardized curriculum and inadequate clinical exposure and skills training. A number of remedies were proposed, such as standardizing curriculum and furthering faculty involvement, utilizing technology as time-effective learning aids, and employing innovative teaching approaches such as service learning. CONCLUSION In light of challenges in ophthalmology education, curriculum designers should consider Cognitive Load Theory (CLT) to assist students to remember meaningful exposures to ophthalmology knowledge and techniques. Based on CLT, we suggest two potential approaches to incorporating ophthalmology curriculum. The first is to embrace interdisciplinary collaborations and place ophthalmology knowledge in varied contexts to facilitate schema construction. The second is to incorporate ophthalmology diagnostics requirements into OSCEs and utilize simulation models for students to gradually increase the fidelity of tasks and devote cognitive resources fully to learning.
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Affiliation(s)
- Jennifer Liao
- Department of Ophthalmology, The Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
| | - Robin Redmon Wright
- Department of Behavioral Sciences and Education, Pennslyvania State University Harrisburg, Middletown, PA, USA
| | - Gargi K Vora
- Department of Ophthalmology, Yale School of Medicine, New Haven, CT, USA
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3
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Robertson EM, Allison SM, Mueller CM, Ferriby AC, Roth AR, Batra R. Exploring effectiveness in brain removal techniques: A comparison of approaches. ANATOMICAL SCIENCES EDUCATION 2024; 17:147-156. [PMID: 37638528 DOI: 10.1002/ase.2333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/27/2023] [Accepted: 08/15/2023] [Indexed: 08/29/2023]
Abstract
Brain dissection is typically an important part of teaching neuroscience in health professional programs. This results in the need to effectively remove brains, which is often performed in a gross anatomy laboratory in the same curriculum. The aim of this study was to determine the most effective method of brain removal based on the time required for removal, difficulty of removal, and preservation of key brain structures for educational purposes. Six different dissectors performed each of the three calvaria removal approaches and three different spinal cord transection methods rating them for difficulty and tracking the time required. The combination of calvaria and brainstem approaches and the order of completion was randomized to control for fatigue and previous individual experience. After all brains were removed, each was evaluated by neuroscience faculty for utility in education contexts. The study found little difference between the individual approaches for both calvaria removal and spinal cord transection in regards to quality of outcome. The use of a circumferential cut only proved to be the most time-effective method for calvaria removal while a posterior cut between C1 and C2 was the most time-effective and least difficult method for brainstem release. There was no one technique that proved to be most beneficial across all three measures. However, different approaches resulted in a different combination of benefits across the time, difficulty, and outcome ratings that should be considered in light of the individual needs of any program or researcher.
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Affiliation(s)
- Ellen M Robertson
- Department of Physician Assistant Studies, Randolph-Macon College, Ashland, Virginia, USA
| | - Sara M Allison
- Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
| | - Caroline M Mueller
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio, USA
| | - Andrew C Ferriby
- Department of Anatomy and Cell Biology, The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia, USA
| | | | - Ranjan Batra
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA
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4
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Patil NS, Bal M, Khan Y. Medical student competence in ophthalmology assessed using the Objective Standardized Clinical Examination. Indian J Ophthalmol 2023; 71:2218-2221. [PMID: 37202953 PMCID: PMC10391480 DOI: 10.4103/ijo.ijo_2108_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To assess pre-clerkship and clerkship medical student performance in an ophthalmology Objective Standardized Clinical Examination (OSCE) station. Methods One hundred pre-clerkship medical students and 98 clerkship medical students were included in this study. The OSCE station consisted of a common ocular complaint - blurry vision with decreased visual acuity - and students were asked to take an appropriate history, provide two or three differential diagnoses to explain the symptoms, and perform a basic ophthalmic examination. Results Generally, clerks performed better than pre-clerks in the history taking (P < 0.01) and ophthalmic examination (P < 0.05) sections, with few specific exceptions. In the history-taking section, more pre-clerkship students asked about patient age and past medical history (P < 0.00001) and for the ophthalmic examination, more pre-clerkship students performed the anterior segment examination (P < 0.01). Interestingly, more pre-clerkship students were also able to provide two or three differential diagnoses (P < 0.05), specifically diabetic retinopathy (P < 0.00001) and hypertensive retinopathy (P < 0.00001). Conclusion The performance of both groups was generally satisfactory; however, many students in both groups had scores that were unsatisfactory. Notably, pre-clerks also outperformed clerks in certain areas, which emphasizes the importance of revisiting ophthalmology content through clerkship. Awareness of such knowledge can allow medical educators to incorporate focused programs into the curriculum.
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Affiliation(s)
- Nikhil S Patil
- Michael G. Degroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Manpartap Bal
- Department of Ophthalmology, Queen's University, Kingston, Ontario, Canada
| | - Yasser Khan
- Department of Ophthalmology, McMaster University, Hamilton, Ontario, Canada
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Singh M, Sharma M, Nair AG, Mehta A, Kaur M, Gupta R, Gupta T, Sahni D. Cadaver dissection for oculoplastic procedures: A beginner's guide. Indian J Ophthalmol 2022; 70:3239-3244. [PMID: 36018092 DOI: 10.4103/ijo.ijo_3037_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The purpose of this article is to form a basic guide for beginning the cadaver dissection training programs focused on oculoplastic surgical procedures. Ours was a collaborative study between the departments of Ophthalmology and Anatomy in a tertiary care teaching institute. We formed a step-wise approach to begin the cadaver dissection focused on the oculoplastic surgical procedures. The basics of cadaver procurement, processing, and preparation for dissections were described. The operative requirements of trainees, surgical handling of cadavers, and basic oculoplastic surgical steps were discussed. The types of embalming (cadaver preservation process) and steps have been described in detail. We have emphasized the preoperative discussion about the proposed dissections using standard teachings and skull models for easier understanding. Additional helping tools like soft embalming and injectable substances for better intra-dissection understanding (intra-arterial, intravenous and orbital injections) have been described. Post-dissection cadaver handing and soft-tissue disposal protocols have also been described. Overall, the cadaver dissections provide holistic surgical learning for the residents, specialty trainees, and practitioners. This article may act as a basic step-wise guide for starting the cadaver-based oculoplastics lab dissection in various institutes and workshops.
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Affiliation(s)
- Manpreet Singh
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manjula Sharma
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay G Nair
- Ophthalmic Plastic Surgery and Ocular Oncology Services, Aditya Jyot Eye Hospital, Mumbai; Ophthalmic Plastic Surgery and Ocular Oncology Services, Advanced Eye Hospital and Institute, A Unit of Dr. Agarwal's Eye Hospitals, Navi Mumbai; Lokmanya Tilak Municipal Medical College and General Hospital, Dr. Babasaheb Ambedkar Road, Sion, Mumbai, Maharashtra, India
| | - Aditi Mehta
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manpreet Kaur
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Richa Gupta
- Department of Anatomy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Tulika Gupta
- Department of Anatomy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Daisy Sahni
- Department of Anatomy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Scantling-Birch Y, Naveed H, Tollemache N, Gounder P, Rajak S. Is undergraduate ophthalmology teaching in the United Kingdom still fit for purpose? Eye (Lond) 2022; 36:343-345. [PMID: 34462584 PMCID: PMC8807702 DOI: 10.1038/s41433-021-01756-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/04/2021] [Accepted: 08/18/2021] [Indexed: 02/03/2023] Open
Affiliation(s)
- Y Scantling-Birch
- Department of Medicine, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK.
| | - H Naveed
- Ophthalmology Unit, Royal Surrey County Hospital, Royal Surrey NHS Foundation Trust, Surrey, UK.,Brighton and Sussex Medical School, Falmer Campus, Brighton, UK
| | - N Tollemache
- Department of Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - P Gounder
- Department of Oculoplastics, Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK.,Ophthalmology Unit, Royal Perth Hospital, The University of Western Australia, Perth, WA, Australia
| | - S Rajak
- Brighton and Sussex Medical School, Falmer Campus, Brighton, UK.,Department of Oculoplastics, Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
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Sparacino AM, Gonzalez VH, Ball S, Cielocha JJ, Helm K, McLeod DS. A Quantitative Analysis of Four Undergraduate Human Anatomy Laboratory Curricula: Approaches, Identified Structures, Concepts, and Thematic Emphases. MEDICAL SCIENCE EDUCATOR 2019; 29:101-111. [PMID: 34457457 PMCID: PMC8368110 DOI: 10.1007/s40670-018-00639-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Human anatomy is a foundational course thatserves diverse pre-professional health care majors. However, limited information is available on the teaching approaches, content, and thematic emphases of this course at the undergraduate level when compared with that of medical and other graduate schools. Herein, we document and quantitatively evaluate the laboratory curriculum of four undergraduate human anatomy courses in the USA. For each course, we assess the total number of structures (terms requiring identification during an exam), concepts (terms requiring an explanation), and clinical applications. To facilitate further assessments, we also compare the content distribution of each course with that recommended by the American Association of Clinical Anatomists (AACA). Two courses followed a regional approach emphasizing the use of human cadavers, while the other two followed a system-based approach and used plastic models and non-human cadaveric materials (e.g., cats and sheep). The total amount of information presented to students differed significantly among curricula. The majority of terms (65-88%) taught to students referred to the identification of anatomical structures whereas clinical applications were rare (< 1.3%). Courses using a regional approach expected students to learn as much as twice the number of terms than those following a system-based approach. Functions, innervations, origins, and insertions of muscles are only included in the curriculum of the courses following a regional approach. The proportion of terms devoted to each anatomical module in all curricula was significantly different from each other, as well as from that of AACA recommendation. We discuss these differences in the curriculum, the challenges and limitations inherent with each teaching approach, as well as in the teaching materials used among the curricula. These quantitative analyses aim to provide insightful information about the structure of the undergraduate human anatomy laboratory curriculum and may prove useful when redesigning a course.
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Affiliation(s)
- Ann Marie Sparacino
- Undergraduate Biology Program, University of Kansas, Haworth Hall, 1200 Sunnyside Avenue, Lawrence, KS 66045 USA
| | - Victor H. Gonzalez
- Undergraduate Biology Program, University of Kansas, Haworth Hall, 1200 Sunnyside Avenue, Lawrence, KS 66045 USA
| | - Sue Ball
- Biological Sciences, Southwestern Oklahoma State University, 100 Campus Drive, Weatherford, OK 73096 USA
| | | | - Katharine Helm
- Department of Health Sciences, James Madison University, Harrisonburg, VA 22807 USA
| | - David S. McLeod
- Department of Biology, James Madison University, Harrisonburg, VA 22807 USA
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8
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Ezeanosike E, Azu-Okeke JC, Achigbu EO, Ezisi CN, Aniemeka DI, Ogbonnaya CE, Chuka-Okosa CM. Cost-Effective Ophthalmic Surgical Wetlab Using the Porcine Orbit with a Simple Dissection Protocol. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojoph.2019.94020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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9
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Santer V, Chen Y, Kalia YN. Controlled non-invasive iontophoretic delivery of triamcinolone acetonide amino acid ester prodrugs into the posterior segment of the eye. Eur J Pharm Biopharm 2018; 132:157-167. [PMID: 30266666 DOI: 10.1016/j.ejpb.2018.09.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/20/2018] [Accepted: 09/24/2018] [Indexed: 12/30/2022]
Abstract
This study investigated short duration transscleral iontophoretic delivery of four triamcinolone acetonide (TA) amino acid ester prodrugs (TA-AA) (alanine, Ala; arginine, Arg; isoleucine, Ile and lysine, Lys) using whole porcine eyes globes in vitro. Post-iontophoretic biodistribution of TA was quantified by UHPLC-MS/MS in the different ocular compartments (cornea, aqueous humor, sclera, ciliary body, choroid and retinal pigmented epithelium (RPE), neural retina and vitreous humor). Transscleral iontophoresis (3 mA/cm2 for 10 min) increased total drug delivery of the TA-AA prodrugs by 14-30-fold as compared to passive diffusion. The TA-AA prodrugs had distinct biodistribution profiles - the penetration depth achieved was dependent on their physicochemical properties (e.g. lipophilicity for TA-Ile) and susceptibility to hydrolysis (e.g. TA-Arg). Intraocular drug distribution was also influenced by prodrug binding to melanin (TA-Lys). Interestingly, under conditions of equivalent charge (6 mA/cm2 for 5 min vs. 1.5 mA/cm2 for 20 min, i.e. 1.44 C respectively) the longer duration (20 min) at lower current density resulted in ∼6 times more TA delivery into the vitreous humor. Overall, the study provided further evidence of the potential of transscleral iontophoresis for the non-invasive treatment of posterior segment inflammatory diseases.
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Affiliation(s)
- Verena Santer
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, CMU-1, rue Michel Servet, 1211 Geneva 4, Switzerland
| | - Yong Chen
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, CMU-1, rue Michel Servet, 1211 Geneva 4, Switzerland
| | - Yogeshvar N Kalia
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, CMU-1, rue Michel Servet, 1211 Geneva 4, Switzerland.
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10
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Garcia JL, Burrells A, Bartley PM, Bartley K, Innes EA, Katzer F. The use of ELISA, nPCR and qPCR for diagnosis of ocular toxoplasmosis in experimentally infected pigs. Res Vet Sci 2017; 115:490-495. [DOI: 10.1016/j.rvsc.2017.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 07/18/2017] [Accepted: 07/21/2017] [Indexed: 10/19/2022]
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11
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Ramsay E, Ruponen M, Picardat T, Tengvall U, Tuomainen M, Auriola S, Toropainen E, Urtti A, Del Amo EM. Impact of Chemical Structure on Conjunctival Drug Permeability: Adopting Porcine Conjunctiva and Cassette Dosing for Construction of In Silico Model. J Pharm Sci 2017; 106:2463-2471. [PMID: 28479360 DOI: 10.1016/j.xphs.2017.04.061] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/21/2017] [Accepted: 04/24/2017] [Indexed: 10/19/2022]
Abstract
Conjunctiva occupies most of the ocular surface area, and conjunctival permeability affects ocular and systemic drug absorption of topical ocular medications. Therefore, the aim of this study was to obtain a computational in silico model for structure-based prediction of conjunctival drug permeability. This was done by employing cassette dosing and quantitative structure-property relationship (QSPR) approach. Permeability studies were performed ex vivo across fresh porcine conjunctiva and simultaneous dosing of a cassette mixture composed of 32 clinically relevant drug molecules with wide chemical space. The apparent permeability values were obtained using drug concentrations that were quantified with liquid chromatography tandem-mass spectrometry. The experimental data were utilized for building a QSPR model for conjunctival permeability predictions. The conjunctival permeability values presented a 17-fold range (0.63-10.74 × 10-6 cm/s). The final QSPR had a Q2 value of 0.62 and predicted the external test set with a mean fold error of 1.34. The polar surface area, hydrogen bond donor, and halogen ratio were the most relevant descriptors for defining conjunctival permeability. This work presents for the first time a predictive QSPR model of conjunctival drug permeability and a comprehensive description on conjunctival isolation from the porcine eye. The model can be used for developing new ocular drugs.
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Affiliation(s)
- Eva Ramsay
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Centre for Drug Research, Division of Pharmaceutical Biosciences, University of Helsinki, Helsinki, Finland.
| | - Marika Ruponen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Théo Picardat
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Unni Tengvall
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Marjo Tuomainen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Seppo Auriola
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Elisa Toropainen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Arto Urtti
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Centre for Drug Research, Division of Pharmaceutical Biosciences, University of Helsinki, Helsinki, Finland
| | - Eva M Del Amo
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
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Imaging of Scleral Collagen Deformation Using Combined Confocal Raman Microspectroscopy and Polarized Light Microscopy Techniques. PLoS One 2016; 11:e0165520. [PMID: 27806070 PMCID: PMC5091908 DOI: 10.1371/journal.pone.0165520] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 10/13/2016] [Indexed: 11/25/2022] Open
Abstract
This work presents an optospectroscopic characterization technique for soft tissue microstructure using site-matched confocal Raman microspectroscopy and polarized light microscopy. Using the technique, the microstructure of soft tissue samples is directly observed by polarized light microscopy during loading while spatially correlated spectroscopic information is extracted from the same plane, verifying the orientation and arrangement of the collagen fibers. Results show the response and orientation of the collagen fiber arrangement in its native state as well as during tensile and compressive loadings in a porcine sclera model. An example is also given showing how the data can be used with a finite element program to estimate the strain in individual collagen fibers. The measurements demonstrate features that indicate microstructural reorganization and damage of the sclera’s collagen fiber arrangement under loading. The site-matched confocal Raman microspectroscopic characterization of the tissue provides a qualitative measure to relate the change in fibrillar arrangement with possible chemical damage to the collagen microstructure. Tests and analyses presented here can potentially be used to determine the stress-strain behavior, and fiber reorganization of the collagen microstructure in soft tissue during viscoelastic response.
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13
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Bouwer HE, Valter K, Webb AL. Current integration of dissection in medical education in Australia and New Zealand: Challenges and successes. ANATOMICAL SCIENCES EDUCATION 2016; 9:161-170. [PMID: 26147336 DOI: 10.1002/ase.1559] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 05/05/2015] [Accepted: 06/16/2015] [Indexed: 06/04/2023]
Abstract
The reduced use of dissection associated with the introduction of integrated systems problem-based learning curricula, graduate-entry programs and medical school expansion is a frequent topic of discussion and debate in modern medical training. The purpose of this study was to investigate the impact of these changes to the medical education landscape, by looking at the current utilization and integration of dissection in medical schools, in Australia and New Zealand. A survey and an invitation to participate in an interview were distributed to all Australian Medical Council-accredited medical schools. Sixteen schools (76%) responded to the survey and five interviews (24%) were conducted. Dissection was a component of the medical program in 12 of the 16 schools surveyed. The opportunity for medical students to dissect human cadavers was found to be related to whether the medical school was established pre- or post-2000 (P = 0.003) but was not significantly associated to undergraduate- or graduate-entry (P = 0.64), program length (P = 0.59) or the number of commencing students (P = 0.07). The methods used for the delivery and integration of dissection varied between schools. Despite substantial changes to the delivery of anatomy in Australian and New Zealand medical schools, a variety of approaches have been adopted to ensure dissection remains an integral component of medical student education. Based on our findings, a number of recommendations were formulated to encourage the integration of dissection, regardless of the didactics of the program, to enhance the anatomical knowledge of students.
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Affiliation(s)
- Hope Ellen Bouwer
- Medical School, Australian National University, College of Medicine, Biology and Environment, Canberra, Australian Capital Territory, Australia
| | - Krisztina Valter
- Medical School, Australian National University, College of Medicine, Biology and Environment, Canberra, Australian Capital Territory, Australia
| | - Alexandra Louise Webb
- Medical School, Australian National University, College of Medicine, Biology and Environment, Canberra, Australian Capital Territory, Australia
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14
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Kyllar M, Štembírek J, Danek Z, Hodan R, Stránský J, Machoň V, Foltán R. A porcine model: surgical anatomy of the orbit for maxillofacial surgery. Lab Anim 2015; 50:125-36. [PMID: 25925960 DOI: 10.1177/0023677215577923] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Due to its similarity to humans, the pig has proven to be a suitable biomodel for both research purposes and for training medical professionals, particularly in surgical specializations. For example, new implant materials have been tested on pig jaws and pigs have also been used in the development of new surgical techniques. For optimizing the effectiveness of such research or training, detailed data on the anatomy of their particular features are needed. At present, however, only limited information related to surgical and imaging anatomy of the facial and orbital areas of the pig and its comparison to human structures from the experimental surgery point of view is available in the literature. The aim of this study was to obtain such data and to compare the morphological structures of the porcine and human orbital regions and to lay down the foundation for practical use in experimental surgery. Ten pig heads were examined using computed tomography (CT) and magnetic resonance imaging (MRI) and, subsequently, a dissection of the orbit was carried out. Attention was focused on the structure of the orbit (floor, rim and nerves) frequently affected by pathological processes in humans (such as trauma, infection or tumours) and which consequently are frequently the subject of maxillofacial surgery. The porcine orbit is suitable for use in experimental medicine. However, if used in experiments, its anatomical peculiarities must be taken into consideration. Our study presents a foundation of basic knowledge for researchers who plan to use the pig as a biomedical model to investigate alternative treatments in the head region.
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Affiliation(s)
- Michal Kyllar
- Department of Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic Companion Care Animal Surgery, Broadstairs, Kent, UK
| | - Jan Štembírek
- Institute of Animal Physiology and Genetics, V.v.i., Academy of Sciences of Czech Republic, Brno, Czech Republic Department of Oral and Maxillofacial Surgery, University Hospital, Ostrava, Ostrava-Poruba, Czech Republic
| | - Zdenek Danek
- Department of Oral and Maxillofacial Surgery, University Hospital Brno, Brno, Czech Republic
| | - Radek Hodan
- Department of Oral and Maxillofacial Surgery, University Hospital, Ostrava, Ostrava-Poruba, Czech Republic
| | - Jiří Stránský
- Department of Oral and Maxillofacial Surgery, University Hospital, Ostrava, Ostrava-Poruba, Czech Republic
| | - Vladimír Machoň
- Department of Oral and Maxillofacial Surgery, University Hospital Prague, Prague, Czech Republic
| | - René Foltán
- Department of Oral and Maxillofacial Surgery, University Hospital Prague, Prague, Czech Republic
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Adams JW, Paxton L, Dawes K, Burlak K, Quayle M, McMenamin PG. 3D printed reproductions of orbital dissections: a novel mode of visualising anatomy for trainees in ophthalmology or optometry. Br J Ophthalmol 2015; 99:1162-7. [PMID: 25689987 DOI: 10.1136/bjophthalmol-2014-306189] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/15/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND The teaching of human head, neck and orbital anatomy forms a critical part of undergraduate and postgraduate medical and allied health professional training, including optometry. While still largely grounded in cadaveric dissection, this method of instruction is constrained in some countries and regional areas by access to real human cadavers, costs of cadaver bequest programmes, health and safety of students and staff and the shortage of adequate time in modern curricula. Many candidates choosing a postgraduate pathway in ophthalmological training, such as those accepted into the Royal Colleges of Ophthalmology in the UK, Australia and New Zealand programmes and the American Academy of Ophthalmologists in the USA, are compelled as adult learners to revise or revisit human orbital anatomy, ocular anatomy and select areas of head and neck anatomy. These candidates are often then faced with the issue of accessing facilities with dissected human cadaveric material. METHODS In light of these difficulties, we developed a novel means of creating high-resolution reproductions of prosected human cadaver orbits suitable for education and training. RESULTS 3D printed copies of cadaveric orbital dissections (superior, lateral and medial views) showing a range of anatomical features were created. DISCUSSION These 3D prints offer many advantages over plastinated specimens as they are suitable for rapid reproduction and as they are not human tissue they avoid cultural and ethical issues associated with viewing cadaver specimens. In addition, they are suitable for use in the office, home, laboratory or clinical setting in any part of the world for patient and doctor education.
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Affiliation(s)
- Justin W Adams
- Department of Anatomy & Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Lisa Paxton
- Department of Anatomy & Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Kathryn Dawes
- Department of Anatomy & Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Kateryna Burlak
- Department of Anatomy & Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michelle Quayle
- Department of Anatomy & Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Paul G McMenamin
- Department of Anatomy & Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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Pescina S, Govoni P, Potenza A, Padula C, Santi P, Nicoli S. Development of a Convenient ex vivo Model for the Study of the Transcorneal Permeation of Drugs: Histological and Permeability Evaluation. J Pharm Sci 2015; 104:63-71. [DOI: 10.1002/jps.24231] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/02/2014] [Accepted: 10/03/2014] [Indexed: 11/05/2022]
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González Del Valle F, Álvarez Portela M, Lara Medina J, Celis Sánchez J, Barrajón Rodríguez A. [Technique for removing donor sclera by eyeball extrusion]. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2012; 87:294-296. [PMID: 22824649 DOI: 10.1016/j.oftal.2011.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 07/08/2011] [Accepted: 07/19/2011] [Indexed: 06/01/2023]
Abstract
PURPOSE To describe a surgery technique for removing donor sclera tissue after corneo-scleral button excision. RESULTS The extrusion technique is easy to perform. It allows the complete scleral extraction its total clean up to be performed, as well as making easier to isolate the retina and uveal tissue. This technique could have an important role in the anatomical and morphological study of ocular structures.
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Affiliation(s)
- F González Del Valle
- Servicio de Oftalmología, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
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Abstract
Although there appears to have been an increase in literature about the anatomy and physiology of the pig eye because of an expansion in its use as a model for research, there has been little written about the development of veterinary medicine in the area. Pig eyes share many similarities with human eyes, having a holangiotic retinal vasculature, no tapetum, cone photoreceptors in the outer retina, and a similar scleral thickness, rendering them valuable in comparative research. It must not be forgotten, however, that pigs are intelligent sentient animals which use vision as an important sense. Thus, diseases such as congenital cataracts, which impede vision, are important from the perspective of pig welfare. In addition, ocular lesions in this species, as with many others, can be a significant sign of systemic disease.
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Affiliation(s)
- Sheldon Middleton
- Acorn House Veterinary Surgery, Linnet Way, Brickhill, Bedford, MK41 7HN, UK.
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Albanese J, Dugue G, Parvu V, Bajart AM, Lee E. Evaluation of a new disposable silicon limbal relaxing incision knife by experienced users. BMC Ophthalmol 2009; 9:15. [PMID: 20025762 PMCID: PMC2804691 DOI: 10.1186/1471-2415-9-15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Accepted: 12/21/2009] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Previous research has suggested that the silicon BD Atomic Edge knife has superior performance characteristics when compared to a metal knife and performance similar to diamond knife when making various incisions. This study was designed to determine whether a silicon accurate depth knife has equivalent performance characteristics when compared to a diamond limbal relaxing incision (LRI) knife and superior performance characteristics when compared to a steel accurate depth knife when creating limbal relaxing incision. METHODS Sixty-five ophthalmic surgeons with limbal relaxing incision experience created limbal relaxing incisions in ex-vivo porcine eyes with silicon and steel accurate depth knives and diamond LRI knives. The ophthalmic surgeons rated multiple performance characteristics of the knives on Visual Analog Scales. RESULTS The observed differences between the silicon knife and diamond knife were found to be insignificant. The mean ratio between the performance of the silicon knife and the diamond knife was shown to be greater than 90% (with 95% confidence). The silicon knife's mean performance was significantly higher than the performance of the steel knife for all characteristics. (p-value < .05) CONCLUSIONS For experienced users, the silicon accurate depth knife was found to be equivalent in performance to the diamond LRI knife and superior to the steel accurate depth knife when making limbal relaxing incisions in ex vivo porcine eyes. Disposable silicon LRI knives may be an alternative to diamond LRI knives.
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Affiliation(s)
- John Albanese
- Becton Dickinson and Company, 1 Becton Drive, Franklin Lakes, NJ, USA
| | - Geoffrey Dugue
- Becton Dickinson and Company, 1 Becton Drive, Franklin Lakes, NJ, USA
| | - Valentin Parvu
- Becton Dickinson and Company, 1 Becton Drive, Franklin Lakes, NJ, USA
| | - Ann M Bajart
- Ophthalmic Consultants of Boston, Boston, MA, USA
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