Pathology is the laboratory science that deals with the changes in normal physiological functions that cause disease. It is the foundation of clinical medicine and, by its role in classifying and describing the natural history of disease, it is important in the control and design of treatment. As a science it is also directed towards determining the cause of disease, a role perhaps most readily perceived in the identification of a specific bacterium causing infection; less obviously in providing accurate knowledge of causes of death as the basis of epidemiological studies. The course deals with a number of basic problems in general pathology, as well as providing an opportunity for the detailed study of a number of specialist topics in experimental pathology, which reflect the research interests of the contributing staff. The course is divided into formal lectures, seminars and an experimental project.
The taught part of the course is divided into 4 units (choice of 5), the rationale and aims of which are listed below. Students can take two units in the first term and two in the second or three units in the first term and one in the second. It is the decision of the student how he/she wishes to schedule the time. Taught modules are assessed by written examinations each of either 2.5-3 hours which are normally held in the last weeks of May or first week of June.
First Term:
1) Functional
Materials in Medical Engineering (MAT306)
Rationale
The purpose of this course is to
understand the structure – function relationship of different classes
of materials used in medical applications and to determine the performance
of these materials in vivo. This knowledge is important for a proper understanding
of the capabilities and limitations of hard and soft tissue prosthetics, as
well as devices such as intravascular stents and implanted sensors.
Objectives
The course will enable students
to understand the structure-function relationship of materials utilised in
medicine. Emphasis will be placed on the complex nature of the natural materials,
their characterisation, and the engineering challenges in their replacement
and repair. The students will understand the standard material characterisation
principles and methods, the development of methodologies specifically for
biomaterials, and their application to a range of materials. The students
will understand the material – tissue interaction in vivo. Through a
series of case studies, students will appreciate the importance of engineering
principles and material selection.
Syllabus
Structure: Crystalline
and amorphous solids, atoms, unit cells.
Metals, ceramics and polymers applied in medicine: Critical appraisal. Metals:
crystal cooling-curves, solidification, nucleation and growth, undercooling,
grain size and porosity; casting; hot and cold working. Polymers: polymerisation
processes. Ceramics processing.
Mechanics: Concept of stress and strain, engineering and true. Methodologies
for simple tensile and compression tests. Typical stress-strain curves and
resulting parameters. Linear and non-linear elastic behaviour – Young’s
modulus, tangent moduli and hysteresis. Plastic deformation. Viscoelastic
behaviour, including definition of creep and stress relaxation. Determination
of material properties from derived parameters including hardness.
Failure of materials: Brittle and ductile fracture. Fracture mechanics. Creep
and fatigue.
Biomaterial evaluation. Biocompatibility and modulus matching: Test methodologies
in biomaterials. Material response – concept of swelling/leaching, degradation,
and corrosion. Host-tissue response, short-term response, wound healing. Undesirable
long-term response and biomechanical adaptation. Spectrum including bio-inert,
bio-active and biodegradable materials.
Hard tissues structure-function relationship. Hierarchical structure of cortical
bone. Test methodologies. Typical mechanical properties in tension & compression.
Changes with structure, age and disease. Synthetic and/or hybrid options for
bone repair. Evaluation for success.
Soft tissues structure-function relationship: Structure of articular cartilage,
tendon/ligaments and blood vessels. Test methodologies. Typical mechanical
properties in tension, compression and dilation. Changes with structure, age
and disease. Synthetic or hybrid options for soft tissue repair. Evaluation
for success.
Biomechanics of joints, the hip joint: Lubrication of healthy joints. Disease
and trauma of joints. Design of artificial joints. Material and geometric
factors. Wear and lubrication of replacement joints.
Fracture fixation: Bone fractures and in vivo repair mechanisms. Orthopaedic
fixation strategies and systems.
2) Experimental
Neuropathology
Rationale
The module covers the areas of brain injury due to mechanical trauma as well
as neuro-degeneration, with emphasis on the research techniques that may be
used to study the pathogenesis of disorders. These include the use of animal
models of neurological disease, genetic mapping and gene expression techniques,
as well as the field of proteomics, just to name a few.
Objectives
To understand the pathogenesis of head injury at a cellular and molecular
level, and the sequence of events following on from the initial insult. To
understand the use of animal models in the study of neurological disease.
To understand neurodegeneration and some of the approaches used in the study
of such disorders. To understand the principles and the basis of the study of gene expression. The module will complement
the syllabus in basic neurosciences, and is strongly linked at a technical
and applied level to the clinical neurosciences.
Syllabus
Genetic factors in disease including: non-Mendelian inheritance, genes and
disease, genetic modelling of disease, and phenotype analysis, axonal transport,
mechanisms of neuronal death. The general pathology of head injury, neuro-degeneration
and demyelination. Specific neuro-degenerative diseases, including: motor
neuron, Alzheimer’s, and Parkinson’s diseases. Technical aspects of how experiments were performed in order to increase our understanding of these and other conditions will also be covered.
3) Cardiovascular
Pathophysiology
Rationale
The module outlines sufficient fluid dynamical and elasticity theory to cover
extensible and non-linearly elastic materials such as arteries, and the behaviour
of blood flowing in them. The material properties of the arterial system are
discussed. This theoretical background provides the basis for understanding
the mechanical factors that underlie the development and progression of vascular
disease. This approach is not commonly followed in the preclinical medical
course, but it provides an essential adjunct to the biochemical and metabolic
description of cardiovascular disease that students will encounter in their
clinical studies.
Objectives
To understand the normal development of the cardiovascular system in terms
of the changing demands on the system during growth and ageing. This approach
is extended to elucidate the pathogenesis of cardiovascular disease in terms
of the response of cells in the vascular wall to changes in mechanical load
such as increased blood pressure or reduced flow. To integrate this model
of vascular pathology with epidemiological factors such as fetal malnutrition,
which affect vessel development in early life and which are linked to an increased
incidence of vascular disease in middle age. Finally, as a means of diagnosing
and treating these problems, to gain an understanding of non-invasive measurement
techniques to monitor the development of abnormal blood vessel properties.
Syllabus
Basic theory of elasticity, non-linear and viscoelastic description of arteries.
Introduction to haemodynamics, pulsatile flow in distensible tubes, wave reflection.
Structure and composition. Models of vascular elasticity and the relationship
between arterial structure and function. The effect of age and vascular disease
on this relationship. Response of the arterial system to chronic changes in
pressure and flow. Endogenous control of vascular tone and the control of
blood pressure. Mechanical factors in hypertension. Non-invasive measurement
of vascular elasticity. Novel treatments for vascular disease.
Second term:
4) Inflammation
and Special Topics in Pathology
Rationale
Inflammation is central to many disorders, and chronic inflammatory diseases
are a major source of disability. The module will examine the scope of inflammatory
disorders, the causes of inflammation, how to treat it and how it should be
assessed, both experimentally and clinically. The principal aim is to understand
the mechanisms and treatments of common chronic inflammatory disorders. The
module will also cover a variety of additional topics in developmental and
tumour pathology. Material covered in many of the lectures will reflect the
research interests of the speakers, and will include such diverse subjects
as gastro-intestinal and genito-urinary tumours, and ageing and oncogenes.
Objectives
The main aim of this module is to understand the pathogenesis of inflammatory
disease. The module offers students the opportunity to see how the theoretical
ideas concerning the causes of acute and chronic inflammation are applied
to the understanding of common forms of inflammatory disease. It allows them
to explore aspects of the subject to a greater depth than is normally possible
in the clinical course.
Syllabus
Topics include: overview of inflammation, mechanisms of inflammatory pain,
animal models of inflammation, gene and protein therapies based on animal
studies, mediators of inflammation, regulation of acute inflammation, mechanisms
of auto-immune disease, and neuro-endocrine immune regulation of inflammation.
Special topics include: testicular and prostatic tumours, and pathology of
the bladder.
5) Cancer Biology
Rationale
Objectives
On completion of this course, you should have a clear idea of the distinction
between benign and malignant neoplasia and the factors, which cause a tissue
to loose its ability to control its growth and proliferation. You will be
able to recognise the histological features of various tumours and have an
overview of current techniques for their diagnosis, treatment and prognosis.
However, as a basic science course, the focus will be on the underlying molecular
biological mechanisms of tissue transformation and tumour growth, rather than
clinical aspects of cancer.
Syllabus
The module will start with the definition of neoplasia and will go on to describe
the macro- and microscopic appearance of a range of specific tumours and current
ideas on the molecular and genetic basis of their pathogenesis. The transformation
from normal to malignant tissue will be described together with the manner
in which tumours grow and spread. The course will end with an overview of
tumour diagnosis and general methods of treatment (pharmacological, radiotherapeutic
and surgical).
Timing
Although the exact timing and titles of the lectures varies from year to year, the timetable given here will give you a reasonable idea of when and where the various lectures are held. More detailed timetables will be sent to you before each unit starts.
| Unit 1. | September 28th to December 18th |
3 lectures per week. | QM, Mile End |
| Unit 2. | September 28th to December 18th | 3 lectures per week. | Pharmacy/Pathology Whitechapel |
| Unit 3. | September 28th to December 18th | 3 lectures per week. | Pharmacy/ Pathology Whitechapel |
| Unit 4. | January 4th to end of April | 3 lectures per week. | Whitechapel & Charterhouse |
| Unit 5. | January 4th to end of April | 3 lectures per week. | Whitechapel |
Lectures will normally take place in the mornings so that afternoons are free for project work.
End
of December |
Draft
project introduction |
| End of April | Hand in project report |
| Mid May to First week in June | Written examinations |
| Second week in June | Oral examinations |
Go back for outlines of potential projects and contact details of their supervisors. For more details about particular projects you should contact the relevant person directly and, if possible, arrange to see them in person.
The project will normally be a piece original research which is expected to occupy at least half of your time throughout the course. It is presented as a written report which will be marked by one of the internal examiners and the external examiner. Normally the examiners’ questions during the viva will be concerned with the project rather than the written exam. If the work is suitable, it may be published in a scientific journal (possibly combined with the results of other BSc projects) and/or be presented, orally or in the form of a poster, at a scientific meeting. However, publication or even presentation of the work you do is not guaranteed.
The project will normally involve experimental work or measurements on patients undergoing clinical investigation. You will be expected to learn the data and word processing skills, necessary to interpret and report the results of your investigations.
There are few formal requirements about the layout or organisation of the project report although it should not exceed 8000 words excluding appendices. It must start with an abstract that explains the reason for doing the experiments, the methods used, the results and conclusions. The main body of the report is often divided into sections like a journal paper: introduction, materials, results, discussion, appendices, references etc. The introduction would normally consist of sufficient historical and theoretical background to justify the experiments to be done and or the hypothesis to be tested. The methods section should provide an overview of all techniques used, including statistical analysis if any, and sufficient explanation of unusual or novel methods to justify their use. Additional information, in enough detail to allow the work to be repeated, should be included in one or more appendices. The results section should provide a detailed record of all work carried out during the course of the project including pilot experiments and all failures. Raw data should be included in one or more appendices. The discussion would normally contain a critical analysis of the methodology and should include explanations of any ‘failed experiments’. A careful analysis of accuracy and estimation of the size of errors is essential. The second part of the discussion should be concerned with the results and would normally include a critical comparison with those of other studies, an analysis of their repercussions and, if appropriate, of the extent to which they confirm the original hypothesis.
The project work should start at the beginning of the first semester and will often begin with a literature search and other background reading. The experimental work might start soon afterwards and should be well established by Christmas. It is a good idea to aim for the introductory sections of the report to be finished by the new year or, to avoid potential spoilage of Christmas holidays, by mid December. The report must be completed and two bound copies, handed in to the course organiser on the last Monday of April, no later than 5 PM. It is important that the experimental work is essentially complete by the end of March, allowing a month for the report to be written and all editorial work to be completed. Your supervisor may wish to see drafts of the project report well before the deadline. Extensions to the deadline are not negotiable.
At the start of the course you will attend an introductory talk on safety in the laboratory and codes of practice for laboratory work, and you will be given documents about these issues. It is very important that you read these carefully before starting any experimental work
If you are having any difficulty in understanding the lectures or in organising your time between project work and lectures, please do not hesitate to contact any of the lecturers or the course organiser, Dr Cathy Baker (Tel. 020 7882 2291, e-mail c.s.baker@qmul.ac.uk). If the experiments aren’t working don’t despair. This is the normal state of affairs in all laboratories. The trick is to know when to persist with a technique and when to give up. Your supervisor or a technician/PhD student/post doc working in the lab are the best people to talk to about this kind of problem. You are also encouraged to talk to the course organiser about this kind of problem as well.