[Colorectal cancer--experiences with the use of standardized forms for reporting pathologic-anatomic data]. / Kolorektalcancer--erfaringer med bruk av maler for rapportering av patologisk-anatomiske data.

BACKGROUND: Colorectal cancer is the second most common cancer among both men and women in Norway. The quality of the information given in the histopathological report is crucial for staging and treatment, and standardised reports are recommended. Such standardised schemes for histopathological reporting and surgical specimen handling were introduced from 1 July 1996 and 1 January 1998, respectively. The present study was undertaken in order to evaluate these schemes and to investigate to what extent the procedures complied with international recommendations. MATERIAL AND METHODS: An evaluation of all histopathological reports from 390 patients operated for colorectal carcinomas and registered at the Department of Pathology of the Central Hospital of Rogaland 1 July 1996 to 30 June 1999. RESULTS: The standardised schemes were used in 184 of 193 cases of surgical specimen handling (95%) and in 381 of 390 cases of histopathological reporting (98%). The quality of the histopathological reports, was in good agreement with international recommendations with respect to most data items. However, the average number of 9.0 lymph nodes sampled was below the minimum of 12 recommended by the International Union Against Cancer. In 29% of the cases, less than six lymph nodes were found. INTERPRETATION: Although the standardised schemes were used almost uniformly, the schemes did not ensure by themselves that all data items were in accordance with international recommendations. The fact that too few lymph nodes were sampled, was only detected during the present evaluation. Thus, any introduction of standardised schemes should include a regular follow-up to ensure that predefined goals are attained.

Spinal cord transection--no loss of distal ventral horn neurons. Modern stereological techniques reveal no transneuronal changes in the ventral horns of the mouse lumbar spinal cord after thoracic cord transection.

Anterograde transneuronal degeneration is caused by the loss of afferent input to the nerve cells and may occur in a number of neuronal systems. Transection of the adult spinal cord, causing anterograde transneuronal degeneration in ventral horn neurons, distal to the lesion, has been reported by some authors, while others contend that no such changes take place. The present study was undertaken in order to investigate whether transection of adult mouse thoracic spinal cord induces neuronal death in the ventral horns distal to the lesion. By means of modern stereological techniques such as the optical dissector, the total number of cells in the lumbar ventral horns was estimated 7 weeks after transection. The mean numbers of neurons and glial and endothelial cells were 82,000 versus 89,000, 259,000 versus 301,000, and 129,000 versus 144,000 in the transected (n = 6) and sham-operated animals (n = 5), respectively. These differences were not statistically significant. Furthermore, neuronal soma volume was estimated by another stereological method, the vertical rotator. Mean neuronal soma volume was not significantly different between transected (2762 microns 3) and sham-operated (2617 microns 3) mice. Although no reduction in cell number or neuronal soma volume was observed, the mean volume of the ventral horns in the lumbar segments was significantly less in transected than in sham-operated animals, 2.49 mm3 versus 3.05 mm3 (P < 0.05). In conclusion, the transection of adult mouse thoracic spinal cord does not induce neuronal degeneration in the lumbar ventral horns.

Spinal Cord Transection-No Loss of Distal Ventral Horn Neurons

Anterograde transneuronal degeneration is caused by the loss of afferent input to the nerve cells and may occur in a number of neuronal systems. Transection of the adult spinal cord, causing anterograde transneuronal degeneration in ventral horn neurons, distal to the lesion, has been reported by some authors, while others contend that no such changes take place. The present study was undertaken in order to investigate whether transection of adult mouse thoracic spinal cord induces neuronal death in the ventral horns distal to the lesion. By means of modern stereological techniques such as the optical disector, the total number of cells in the lumbar ventral horns was estimated 7 weeks after transection. The mean numbers of neurons and glial and endothelial cells were 82,000 versus 89,000, 259,000 versus 301,000, and 129,000 versus 144,000 in the transected (n = 6) and sham-operated animals (n = 5), respectively. These differences were not statistically significant. Furthermore, neuronal soma volume was estimated by another stereological method, the vertical rotator. Mean neuronal soma volume was not significantly different between transected (2762 &mgr;m3) and sham-operated (2617 &mgr;m3) mice. Although no reduction in cell number or neuronal soma volume was observed, the mean volume of the ventral horns in the lumbar segments was significantly less in transected than in sham-operated animals, 2.49 mm3 versus 3.05 mm3 (P < 0.05). In conclusion, the transection of adult mouse thoracic spinal cord does not induce neuronal degeneration in the lumbar ventral horns. Copyright 1997 Academic Press. Copyright 1997 Academic Press

[Primary health care and emergency admission of patients. What happened prior to admissions and how did the patients experience the primary health care system?]. / Primaerhelsetjenesten og pasienter som innlegges for øyeblikkelig hjelp. Hva skjedde før pasientene ankom sykehus, og hvordan opplevde pasientene kontakten med primaerhelsetjenesten?

Of 238 patients admitted to Haugesund hospital, 159 completed a questionnaire evaluating the primary health care system and describing events before admission to hospital. Half of the patients had contacted the health care system within one hour after onset of symptoms. Two thirds of the 159 patients had consulted a general practitioner, while 33 patients had used the emergency telephone number or had gone directly to the hospital. Two thirds of the patients who had been examined by a general practitioner were visited within an hour after first contact. According to the questionnaires, 58 patients visited at home were sicker than the 62 patients examined at the doctor's surgery. No such difference was found, however, by the junior doctor who examined the patients upon admission to hospital. Apart from the 11 patients who felt rejected at their first contact with the health personnel, the patients judged this first contact with the primary health care system and the general practitioner to be very satisfactory.

[Emergency hospital admissions. A survey and consumer assessment of conditions in an emergency department admission office]. / Oyeblikkelig hjelp-innleggelser i sykehus. En kartlegging og brukerundersøkelse av forholdene i en mottakelsesavdeling.

159 patients admitted to a local hospital completed a questionnaire during the autumn of 1992 in order to evaluate the service rendered to the patients during their stay in the admission/emergency unit. The patients were generally satisfied with the service rendered in the admission/emergency unit. However, some patients were dissatisfied with the information given by the nurses and the doctors. 83 of the patients (57%) were examined by a doctor within 15 minutes after admission. Information about how long and why they had to wait increased the level of satisfaction among the patients who had to wait more than 15 minutes. With respect to the patients' rating of different skills among nurses and doctors, only 37% of the patients rated technical competence as the most important factor for the nursing profession, as opposed to 59% for the doctors. For both professions the ability to give information was rated as the second most important factor. Since the comments from the patients reflect parts of the service that can be changed, we believe such surveys can be of great value for the hospitals' efforts to improve the service provided.

Autometallographic demonstration of mercury in rat molars.

Male, adult Wistar rats were exposed to 500 micrograms/m3 mercury vapor 6 h per day, 5 days a week for 4 wk. They were subsequently killed by transcardial perfusion. The molars were extracted, demineralized, and embedded in resin before sectioning. Autometallographic development was performed according to the method of Danscher & Möller-Madsen. Mercury deposits were found in small amounts in several areas of the pulp, but with larger accumulations of grains in relation to odontoblasts. Mercury also could be seen in odontoblastic processes in the dentin and predentin. Our conclusion is therefore that systemic uptake of mercury vapor leads to accumulation of mercury in the odontoblasts and that the mercury may be transported into the dentin tubules in the odontoblastic process.

The use of the optical disector to estimate the number of neurons, glial and endothelial cells in the spinal cord of the mouse--with a comparative note on the rat spinal cord.

By means of stereological techniques such as the optical disector, the total number of cells in the spinal cords of five albino mice were estimated. The mean number of cells in the gray and the white matter was 9.0 and 4.1 million, respectively. Of the cells in the gray matter, 4.0 million were classified as neurons, 2.8 million as glial and 1.7 million as endothelial cells whereas 0.4 million remained unclassified. Of the neurons in the gray matter, 1.2 million were located in the cervical region, 1.4 million in the thoracic region, 0.9 million in the lumbar region and 0.4 million in the sacro-coccygeal region. The gray matter in the spinal cord of the mouse contained relatively more neurons and less glial cells than the gray matter in the rat spinal cord. The fraction of cells in the cervical, thoracic, lumbar and sacro-coccygeal part of the cord were, however, quite similar in the two species. In both species the number of neurons in the ventral horns made up about 8-9% of the total neuron population in the gray matter of the cord.

Estimate of the total number of neurons and glial and endothelial cells in the rat spinal cord by means of the optical disector.

The total numbers of neurons and glial and endothelial cells in five rat spinal cords were estimated by stereological techniques. Each spinal cord was divided into 12 slabs of equal length. One transverse and one oblique slice was cut from each slab. The volumes of gray and white matter of each cord were then estimated by point-counting techniques on the transverse slices. By means of optical disectors and systematic sampling, the numerical densities of different cell types were estimated on 35 microns-thick plastic sections from the oblique slices. The total cell number was calculated by multiplying the numerical density by the total volume of gray and white matter. On average there were 15.1 and 21.1 million cells in white and gray matter, respectively. Of the cells in gray matter, 6.4 million were judged to be neurons, 4.3 million to be endothelial, and 10.3 million to be glial. Of the neurons, 1.7 million were located in the cervical region, 2.5 million in the thoracic, 1.6 million in the lumbar, and 0.6 million in the sacro-coccygeal region. The methods used are simple to perform, and the counting necessary to obtain a reliable estimate of cell number from one spinal cord can be carried out during the course of 1 day. The only major problem is reliable criteria for unambiguous cell classification.

[Working conditions of medical students--medical students and research]. / Studentforskernes arbeidssituasjon--medisinstudenter og forskning.

A questionnaire survey was conducted among 33 medical students (22 men and 11 women) working as part or full-time research trainees at the University of Bergen in 1990, in order to examine various aspects of their working conditions. Most trainees (81%) experienced a well-organized initial research project, and 85% were quite content with their personal supervision. The students "defined" two hours per week as an "adequate amount" of supervision. A higher percentage of the male trainees were first author of scientific publications, while a higher percentage of the females felt that they had learned something from their scientific training. Surprisingly perhaps, relatively more of the female wished to do research full time in the future. 94% of the research trainees recommended other medical students to participate in research training programmes during their student career.

[Research interest and recruitment potential--medical students and research]. / Forskningsinteresse og rekrutteringspotensiale--medisinstudenter og forskning.

A questionnaire survey on scientific interest among 324 medical students at the University of Bergen in 1990 showed that 14% of the students had already participated in medical research programmes (10% still research trainees). In addition, 45% had considered starting working as a research trainee while a student. Many were discouraged, however, by the problem of finding a suitable supervisor. Relatively more of the male students expressed considerable interest in science (32 versus 22% of the females). The medical students already recruited to scientific work stressed the importance of scientific experience for their future career. The faculty has recently made participation in research projects compulsory. The personal supervision during this short period (6-8 weeks) will probably have major impact on the interest in research and the recruitment of future medical research trainees.

[Research training--the work situation of research trainees at the School of Medicine, University of Bergen]. / Forskerutdanning--forskerrekruttenes arbeidssituasjon ved Det medisinske fakultet, Universitetet i Bergen.

In an investigation in spring 1989 on research training at the Medical Faculty, University of Bergen, 111 questionnaires were returned of a total of 180 distributed. 35% of the trainees were satisfied with the training, 31% not, while 30% did not know as yet. Trainees who had been full-time research fellows for two years or more (n = 33), were split in two groups with different opinions. Half of them were satisfied with the training programme, and the other half were not. The most important factor linked with the trainees' opinion of the training was personal supervision. The satisfied ones were content with supervision they had received, whereas the unsatisfied ones were not. By and large, office and laboratory conditions were adequate for the trainees, but data equipment had been supplied by many of the trainees themselves. The overall impression of this investigation is that the research training programme is working fairly well, but there is remove for improvement in the supervision of the individual trainee.

[Research training--what trainees think about future research education]. / Forskerutdanning--hva forskerrekruttene mener om fremtidens forskerutdanning.

A research training programme should have a clearly defined aim and a framework for accomplishment and contents. In Norway no such programme exists for the medical PhD. Present research training depends to a large extent on the individual student. The aim of this paper is to contribute to a discussion on the goals for a research programme and to report what research trainees and research fellows at the Medical Faculty, University of Bergen think is necessary as regards framework and content. 111 of 180 questionnaires were returned. On the average, the students preferred a research programme to last 4.0 years. 91 persons wanted the programme to contain a compulsory part lasting, on average, 5.5 months. The majority preferred no examination during this part of the programme. Most students wanted to maintain the present Norwegian standard for the medical PhD.

A stereological study of the ependyma of the mouse spinal cord. With a comparative note on the choroid plexus ependyma.

Applying different stereological techniques, the total ependymal volume in the spinal cord of mice was estimated to be 83 x 10(6) microns cubed, the number of cells to be 163,000 and the mean ependymal cell volume to be 510 microns cubed. Compared to choroid plexus cells in the third ventricle, the ependymal cells in the spinal cord contained a smaller mitochondrial volume (9.8% versus 4.6% of cell volume) and less rough endoplasmic reticulum (2.1% versus 0.4%). These findings indicate that the metabolic activity of the ependyma in the spinal cord is lower than that in the choroid plexus. Compared to liver and exocrine pancreatic cells, ependymal cells in both locations must be considered to have a rather low metabolic activity.

Pharmacological manipulation with the descending serotonergic system or transection of the mouse spinal cord has no effect on ependymal ultrastructure.

In order to investigate an effect of descending nerve fibres on mouse spinal cord ependymal ultrastructure, pharmacological manipulation with the serotonergic system or transection of the spinal cord was done. Biochemical analysis showed an 83% reduction of serotonin content in spinal cord tissue after p-chlorophenylalanine injections and a 93% reduction after transection. However, none of the experimental animals showed changes in ependymal ultrastructure compared to control animals as revealed by electron microscopy.

Ultrastructure of the mouse spinal cord ependyma.

This study was done in order to investigate the normal ultrastructure of well-preserved mouse spinal canal ependyma using light, scanning and transmission electron microscopy. The ependymal lining was found to consist of a simple, cuboidal epithelium essentially similar to the unspecialized cuboidal ependyma of the brain ventricles. Apart from great variation in kinociliary density, no intracellular difference was noted between the ependymal cells. In contrast to earlier findings, indications of the existence of zonulae occludentes between the apical part of the ependymal cells were observed. Our findings do not support the hypothesis of secretion or intracellular transport by the ependyma, or that the ependyma constitutes a significant diffusion barrier.

Preservation of the ependyma of the mouse spinal cord by various vascular perfusion procedures.

Seventy-two mice were used to find out which of 13 vascular perfusion procedures gave best structural preservation of the spinal cord ependyma and central canal lumen. Best results were obtained by 3% glutaraldehyde in Tyrodes solution with 50% of normal NaCl amount, 0.06 M sucrose and 2% dextran T-40 (556 mOsmol, pH 7.2, 0-4 degrees C). This was perfused by a peristaltic pump at 40 ml/min for 10 min through a cannula inserted in the ascending aorta. No advantage was seen by heparin pretreatment or adding a prefixation rinse. With good tissue preservation the central canal was found to be round to oval in cross-sectional profile and almost free of intraluminal material.

Effects of dextran-containing perfusion fixatives on intraluminal compounds in rat kidney tubules.

In the present study on rat kidney tubules an intraluminal, electron-dense granular substance was found in animals perfusion-fixed with dextran-containing fluids. Most findings were made in thick ascending limbs of Henle and distal convoluted tubules. The incidence decreased from 50% to zero when intravascular rinsing time was increased from zero to 70 sec. In animals fixed without dextran no such substance was found. In some thick ascending limbs of Henle and distal convoluted tubules a similar electron-dense substance was found along the apical plasmalemma of some cells. The origin of the observed substances is at present not defined, but may represent a coprecipitation of dextran and (glyco)proteins caused by glutaraldehyde.

Scanning electron microscopy of human urine and purified Tamm-Horsfall's glycoprotein.

Dialyzed and dehydrated human urine and purified Tamm-Horsfall's glycoprotein revealed similar morphology by scanning electron microscopy. Single filaments, with diameters between 15-45 nm, splitting off and merging with thicker fibers at irregular intervals made up a three-dimensional meshwork with submicrometer pores. The resulting "fishing net" is capable of trapping microorganisms and may facilitate their elimination from the urinary tract by micturition. Tamm-Horsfall's glycoprotein may accordingly be a factor protecting against urinary tract infections.