Medicine and Surgery

Content of the course/sylabus: INTRODUCTION. Principles of microscopy: magnification, resolution, chemical basis of staining, dimensions of typical organelles and cells. Instruments: optical and electronic instruments for studying cells and tissues; special types of microscopy (phase contrast, fluorescence, confocal, electron, atomic force). Histological techniques: overview of methods and sample preparations in cytology and histology; tissue preparation for microscopic examination; most common staining dies. Special techniques: histochemistry; immunohistochemistry; immunofluorescence. Issues related to the analysis of histological sections; artifacts. CYTOLOGY. Structural organization and function of the eukaryotic cell. Cytoplasm and nucleus. Cytoplasmic organelles. Plasma membrane. Rough and smooth endoplasmic reticulum. Golgi apparatus and vesicle trafficking. Mitochondria: morphology and homeostasis, fission, fusion, and transfer. Cytoskeleton and centrioles. Inclusions. Cytosol. Nucleus. Nuclear envelope. Chromatin. Nucleolus. Cell cycle, cell proliferation, cell death. Mitosis and meiosis. Cell-to-cell and cell-matrix junctions. EMBRYOLOGY. A: General Embryology - Introduction. Morphogenetic mechanisms: cell growth, migration, and differentiation. Induction, commitment, and determination. Animal models of development. Cellular and molecular analyses of morphogenesis. - Embryonic and adult stem cells, somatic cell reprogramming into pluripotent stem cells (iPS): concepts, definition and potentiality for tissue regeneration and repair. - Gonads, meiosis, male and female gametogenesis. The uterine cycle and its regulation. Hormonal control of gametogenesis. Fertilization. Medically assisted reproduction. - Early stages of the embryo development. Segmentation. Morula. Blastocyst and implantation. The bilaminar embryonic disk. - Gastrulation: timing and 3D formation of primitive layers: endoderm, ectoderm and mesoderm. - Derivatives of the three germ layers. Extra-embryonic tissues and their derivatives. - The notochord and its role in embryo development. - Neurulation: formation of the neural tube, derivatives of the neural tube, neural crest cells - Embryonic folding processes and definition of body cavities: paraxial, and lateral mesoderm derivatives. - Development of trophoblast. Placenta and fetal membranes. Embryo annexes. - Teratogenesis. General etiology and mechanisms of congenital disorders: examples of birth defects, prenatal diagnosis and therapy B: Systems-Based Embryology Initial organogenesis (mostly the embryonic period), with particular reference to the development of: - digestive system: pharyngeal apparatus, foregut, midgut, hindgut - central nervous system and neural crest derivatives, with notes on nerve formation - major exocrine and endocrine glands - cardiovascular system: heart development, lateral mesoderm and circulatory system, vasculogenesis, angiogenesis - respiratory system: respiratory primordium, formation of the larynx, trachea, bronchi, alveoli, stages of lung development (pseudoglandular, canalicular, saccular alveolar) - urogenital system: urinary system (pronephros, mesonephros, metanephros, ureters, urethra and bladder); genital system (primordial germ cells, gonad formation, ducts and external genitals, sex determination) - notes on limb development HISTOLOGY. Introduction to tissues. Histogenesis and homeostasis of tissues. Stem cells. Cell turnover, determination and differentiation. Epithelial tissue: Overview of epithelial structure and function. Classification of the epithelia. Specializations of cells surface and cell polarity. Lining epithelia. Histological structure of epidermis and digestive, respiratory, urogenital mucosae. Serous membranes. Gland tissues. Definition and classification of glands. Mechanisms of secretion. Histogenesis and structure of major exocrine and endocrine glands (pancreas, liver, prostate, salivary, mammary, pituitary, thyroid, parathyroid, adrenal glands). Connective tissues: Connective tissues: general structure and functions of connective tissue; extracellular matrix, fibers, ground substance; basement membranes; cells. Classification of connective tissue. Connective tissue proper: loose, dense, reticular, Adipose tissue: types and functions Cartilage: cells and extracellular matrix. Types of cartilage and their distribution. Perichondrium. Chondrogenesis, cartilage growth and repair. Bone: Bone architecture and functions. Bone matrix. Bone cells. Osteogenesis, bone remodeling and homeostasis. Blood and lymph: erythrocytes, leucocytes, platelets. Plasma and serum. Blood coagulation. Bone marrow. Prenatal and postnatal hemopoiesis. Hematopoietic stem cells, progenitor cells and precursor cells. Immune system and organs, including the histological structure of thymus, spleen and lymph nodes. Muscle tissues: Muscle tissues: types of muscle tissues: overview of structure and function. Morphology and functional characteristics of skeletal muscle. Fine structure of skeletal muscle fibers. Contraction and relaxation. Motor and sensory innervation of skeletal muscle. Neuromuscular junction. Satellite cells and muscle regeneration. Morphology and functional characteristics of cardiac muscle. Fine structure of cardiac muscle fibers; intercalated disk, organelles. Contraction of cardiac fibers. Conducting system of the heart. Morphology and functional characteristics of smooth muscle. Fine structure of smooth muscle fibers. Smooth muscle contraction. Regeneration of muscle tissues. Nervous tissue: Histogenesis, general organization, morpho-functional relationships. Cells of the nervous system. Neuron types and their morphology. The axonal transport system. Synapses and synaptic transmission. The nerve fibers: general structure of nerves, connective tissue investments. Response of neurons to injury. Neuroglia: oligodendrocytes, astrocytes, microglia, ependymocytes, satellite cells, Schwann cells. Special histology and embryology for the students of Dentistry and Dental Prosthodontics only: ORAL HISTOLOGY. In-depth description of the tissues of the oral cavity: oral mucosa, salivary glands, bone, temporomandibular joint, the periodontium, dental tissues: dentin-pulp complex, enamel, cementum. ORAL EMBRYOLOGY. In-depth embryology of the head, face, and oral cavity: pharyngeal arches and their derivatives, hard tissue formation, development of the tooth and its supporting tissues, dentinogenesis and amelogenesis, repair and regeneration of dental tissue, tooth eruption and shedding.

Requirements: Basic knowledge of Physics, Inorganic and Organic Chemistry, Cell Biology and Genetics

The students are free to choose any university level Histology / Embryology textbook, including textbooks not listed here. The selection belo can be used for the preparation of the Histology exam for Medical School students. The student will need one textbook for Histology proper and Cytology, and one for Embryology. The specific items / subjects required to pass the examinations (ongoing and final) are listed in the syllabus, regardless of their presence on individual textbooks. It is recommended that the students consult and study the chosen textbooks in parallel with the class lessons. The lecture presentations, supplied to the students on the eLearning page of the course, are not sufficient for exam preparation. Suggested textbooks: Histology (including essential Cytology)  Gartner LP & Hiatt JL, Color Textbook of Histology, Lippincott Williams & Wilkins, last available edition.  Ross MH & Pawlina W, Histology: a Text and Atlas, Lippincott Williams & Wilkins, last available edition.  Young B & Others, Wheather’s Functional Histology. Churchill Livingstone Elsevier, last available edition. Embriology  Moore K.L. The developing Human. Clinically oriented Embryology, Saunders Elsevier, last available edition.  Sadler T.W. Langman’s Medical Embryology, Lippincott Williams & Wilkins, last available edition.  Shoenwolf G.C. Larsen's Human Embryology, Churchill Livingston Elsevier, last available edition Additional textbooks/references:  Stephen A. Stricker. Human Microanatomy. 2022  Lars I. Larsson. Immunohistochemistry: Theory and Practice. 2020  R. Milo and R. Phillips Cell Biology by the Numbers. 2015 

Teaching methods: Class teaching, labs, seminars

In person; to be admitted at the final exam it is mandatory having attended to at least 67% of the didactic activities

Evaluation methods: ongoing examinations (MCQ tests - waving part of the syllabus in case of success – on: Introduction, cytology, embryology part A); possibility of a bonus for amn active and productive participation to the labs; practical test (tissue identification), final oral examination

Class teaching, labs, seminars, flipped learning

Contents: INTRODUCTION Principles of microscopy: magnification, resolution, chemical basis of staining, dimensions of typical organelles and cells. Instruments: optical and electronic instruments for studying cells and tissues; special types of microscopy (phase contrast, fluorescence, confocal, atomic force). Histological techniques: overview of methods and sample preparations in cytology and histology; tissue preparation for microscopic examination; most common staining dies. Special techniques: histochemistry; immunohistochemistry; immunofluorescence. Issues with histological analysis: issues related to the section analysis; artifacts. CYTOLOGY Structural organization and function of the eukaryotic cell. Cytoplasm and nucleus. Cytoplasmic organelles. Plasma membrane. Rough and smooth endoplasmic reticulum. Golgi apparatus and vesicle trafficking. Mitochondria: morphology and homeostasis, fission and fusion. Cytoskeleton and centrioles. Inclusions. Cytosol. Nucleus. Nuclear envelope. Chromatin. Nucleolus. Cell cycle, cell proliferation (mitosis), cell death. Meiosis. Cell-to-cell and cell-matrix junctions. HISTOLOGY - Introduction to tissues. Histogenesis and homeostasis of tissues. Stem cells. Cell turnover, determination and differentiation. - Epithelial tissue. Overview of epithelial structure and function. Classification of the epithelia. Specializations of cells surface and cell polarity. Lining epithelia. Histological structure of epidermis and digestive, respiratory, urogenital mucosae. - Gland tissues. Definition and classification of glands. Mechanisms of secretion. Histogenesis and structure of major exocrine and endocrine glands (pancreas, liver, prostate, salivary, mammary, pituitary, thyroid, parathyroid, adrenal glands). - Connective tissues: general structure and functions of connective tissue; extracellular matrix, fibers, ground substance; basement membranes; cells. Classification of connective tissue. Connective tissue proper: loose, dense, reticular, - Adipose tissue: types and functions - Cartilage: cells and extracellular matrix. Types of cartilage and their distribution. Perichondrium. Chondrogenesis, cartilage growth and repair. - Bone: Bone architecture and functions. Bone matrix. Bone cells. Osteogenesis, bone remodeling and homeostasis. - Blood and lymph: erythrocytes, leucocytes, platelets. Plasma and serum. Blood coagulation. Bone marrow. Prenatal and postnatal hemopoiesis. Hematopoietic stem cells, progenitor cells and precursor cells. - Immune system and organs, including the histological structure of thymus, spleen and lymph nodes. - Muscle tissues: types of muscle tissues: overview of structure and function. Morphology and functional characteristics of skeletal muscle. Fine structure of skeletal muscle fibers. Contraction and relaxation. Motor and sensory innervation of skeletal muscle. Neuromuscular junction. Satellite cells and muscle regeneration. Morphology and functional characteristics of cardiac muscle. Fine structure of cardiac muscle fibers; intercalated disk, organelles. Contraction of cardiac fibers. Conducting system of the heart. Morphology and functional characteristics of smooth muscle. Fine structure of smooth muscle fibers. Smooth muscle contraction. Regeneration of muscle tissues. - Nervous tissue: Histogenesis, general organization, morpho-functional relationships. Cells of the nervous system. Neuron types and their morphology. The axonal transport system. Synapses and synaptic transmission. The nerve fibers: general structure of nerves, connective tissue investments. Response of neurons to injury. Neuroglia: oligodendrocytes, astrocytes, microglia, ependymocytes, satellite cells, Schwann cells. EMBRYOLOGY A: General Embryology - Introduction. Genetics and molecular biology of human development. Morphogenetic mechanisms. - Gonads, meiosis, male and female gametogenesis. The uterine cycle and its regulation. Hormonal control of gametogenesis. Fertilization. Medically assisted reproduction. - Early stages of the embryo development. Segmentation. Morula. Blastocyst and implantation. The bilaminar embryonic disk. - Embryonic and adult stem cells, somatic cell reprogramming into pluripotent stem cells (iPS): concepts, definition and potentiality for tissue regeneration and repair. - Gastrulation: timing and 3D formation of primitive layers: endoderm, ectoderm and mesoderm. - The notochord and its role in embryo development. - Neurulation - Embryonic folding processes and definition of body cavities - Development of trophoblast. Placenta and fetal membranes. Embryo annexes. - Teratogenesis. General etiology and mechanisms of congenital disorders: examples of birth defects, prenatal diagnosis and therapy B: Systems-Based Embryology Initial organogenesis (embryonic period) with particular reference to the development of: - central nervous system and neural crest derivatives - cardiovascular system - digestive system - respiratory system - urogenital system - major exocrine and endocrine glands - notes on limb development

Requirements: Basic knowledge of Physics, Inorganic and Organic Chemistry, Cell Biology

Suggested textbooks (last edition available: Histology (including essential Cytology) ▪ Gartner LP & Hiatt JL, Color Textbook of Histology, Lippincott Williams & Wilkins. ▪ Ross MH & Pawlina W, Histology: A Text and Atlas, Lippincott Williams & Wilkins. ▪ Young B & Others, Wheather’s Functional Histology. Churchill Livingstone Elsevier. Embriology ▪ Moore K.L. The developing Human. Clinically oriented Embryology, Saunders Elsevier. ▪ Sadler T.W. Langman’s Medical Embryology, Lippincott Williams & Wilkins. ▪ Shoenwolf G.C. Larsen's Human Embryology, Churchill Livingston Elsevier. Additional, reference textbooks: ▪ Alberts and Others, Molecular Biology of the Cell, Garland Science, 2008. ▪ Ross MH, Pawlina W & Barnash TA, Atlas of descriptive Histology, Sinauer Associates, 2009 ▪ Eroschenko VP, Di Fiore's Atlas of Histology with functional correlations, Lippincott Williams & Wilkins, 2007 ▪ Gartner LP & Hiatt JL, Color Atlas of Histology, Lippincott Williams & Wilkins, 2009.

mandatory

Evaluation methods: Ongoing examinations on the Cytology and General Embryology parts (MCQ tests, waving the corresponding part of the syllabus for the oral exam) and final, oral examination on Histology and System-based Embryology.

Teaching methods: Class teaching, labs, seminars,