Medicine and Surgery

NTRODUCTION: Histological techniques: overview of methods in cytology and histology; tissue preparation for microscopic examination; optical instruments for studying cells and tissues. HISTOLOGY: Introduction to tissues. Cell differentiation and histogenesis of tissue. Tissue engineering. Epithelium. Specializations of cells surface and cell polarity. Lining epithelia: generalities and histological structure of epidermis and digestive, respiratory, urogenital mucosae. Glands: histogenesis and structure of major exocrine and endocrine glands (pancreas, liver, prostate, salivary, mammary, pituitary, thyroid, parathyroid, adrenal).Connective tissues. General structure and functions of connective tissue; extracellular matrix, fibers, ground substance and cells; Connective tissue proper. Cartilage. Types of cartilage; chondrogenesis and cartilage growth Bone. Osteogenesis; bone remodeling and homeostasis. Blood: plasma, erythrocytes, leucocytes, platelets. Hemopoiesis. Immune system and organs, including the histological structure of thymus, spleen and lymph nodes. Muscle tissues: morphology and functional characteristics of skeletal, cardiac muscle and smooth muscle. Nervous tissue. Neurons. Nerve fibers. Synapses. Neuroglia. Peripheral nerve terminals. EMBRYOLOGY: Introduction. Gonads, gametogenesis and fertilization. In vitro fertilization. Embryonic and adult stem cells, somatic cell reprogramming into pluripotent stem cells (iPS): concepts, definition and potentiality for tissue regeneration and repair. Early stages of the embryo development. Segmentation. Morula. Blastocyst and implantation. The embryonic disk. Timing and 3D development of primitive layers: endoderm, ectoderm and mesoderm. The notochord and its role in embryo development. Further development and derivatives of ectoderm, endoderm and mesoderm. Placenta. Embryo annexes. Morphogenetic mechanisms. Interactions between primitive layers and initial organogenesis with some examples: central nervous system, circulatory, digestive, respiratory and urogenital systems. Neural crest derivates. Teratogenesis.

The course requires established knowledge of cell biology, as well as general notions of Phisics, inorganic and organic chemistry

The high quality textbooks suggested here 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 students are free to choose any university level Histology / Embryology textbook, including textbooks not listed here. The specific items / subjects required to pass the examinations are listed in the syllabus, regardless of their presence on individual textbooks. Histology: Istologia di V. Monesi, Ed. PICCIN, 7° Ed. Istologia. Testo e atlante, Ross, Pawlina, Casa Editrice Ambrosiana Embryology: Embriologia umana. Morfogenesi, processi molecolari, aspetti clinici De Felici, Ed. Piccin, 2nd Ed. (Further titles and details can be found at: https://elearning.uniroma1.it/course/view.php?id=2170 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. LINKS DIDATTICI http://www.udel.edu/biology/Wags/histopage/histopage.htm http://www.meddean.luc.edu/lumen/MedEd/Histo/frames/histo_frames.html http://lifesci.dls.rutgers.edu/~babiarz/DrBsRev.htm http://www.uni-mainz.de/FB/Medizin/Anatomie/workshop/EM/EMAtlas.html Embriologia medica di Langman, T.W. Sadler, Ed. Elsevier

The teacher delivers lectures with traditional methods with audiovisual aids and scheduling of lessons as reported on GOMP Aure/Orari system, published on the website of the Medical School, and on the course eLearning page: https://elearning.uniroma1.it/course/view.php?id=2170 The course includes labs (use of a compound microscope, analysis of histological preps - see calendar), and integrates electives (ADE) and seminars

The frequency is mandatory. To be admitted to the exam the frequency of at least 67% of the lectures ias required

Multiple choice test (50 questions) followed by oral examination (for whom reached sufficient grade at the written test)

The teacher delivers lectures with traditional methods with audiovisual aids and scheduling of lessons as reported on GOMP Aure/Orari system, published on the website of the Medical School, and on the course eLearning page: https://elearning.uniroma1.it/course/view.php?id=2170 The course includes labs (use of a compound microscope, analysis of histological preps - see calendar), and integrates electives (ADE) and seminars

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) ▪ Adamo, De Felici et al. ISTOLOGIA di Monesi, PICCIN, 7° edizione. ▪ Ross MH & Pawlina W, Histology: A Text and Atlas, Lippincott Williams & Wilkins. ▪ Gartner LP & Hiatt JL, Color Textbook of Histology, Lippincott Williams & Wilkins. ▪ Young B & Others, Wheather’s Functional Histology. Churchill Livingstone Elsevier. Embriology ▪ De Felici, Boitani et al Embriologia Medica, PICCIN 3° edizione ▪ 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: Written exam (multiple choice quiz, 50 questions with 5 answers of which only one is correct) to be passed with a minimum of 30/50 to access the oral examination on Histology and System-based Embryology.

Teaching methods: Class teaching, labs, seminars.