Viewpoint: leaving the "empty glass" of problem-based learning behind: new assumptions and a revised model for case study in preclinical medical education.

The popularity of problem-based learning (PBL) reflects medical educators' recognition that case study can enhance the preclinical medical school curriculum. However, the PBL method itself has features, particularly its reliance on small-group work with tutor-facilitators, that are expensive to implement and that limit the potential educational value of case study. The author systematically analyzes specific aspects of the PBL methodology and concludes that the PBL approach misuses the faculty, tends to compromise the authenticity of cases, and results in an unnecessarily varied and impoverished educational experience for students.

IgA nephropathy in a patient with chronic granulomatous disease.

We report the first documented case of X-linked chronic granulomatous disease (CGD) in association with IgA nephropathy in a 22 year old male with multiple soft tissue abscesses. The case highlights the potential role of staphylococcal infections in the pathogenesis of IgA nephropathy and suggests the hypothesis that the neutrophil defect in CGD predisposes to such infections which may trigger IgA immune complex formation.

Oxygen metabolites and hypoxic renal injury: effect of mitochondrial electron transport blockade.

Isolated perfusion of the rat kidney causes hypoxic damage in the cells of the thick ascending limb of the loop of Henle. The cell damage is driven by active solute transport, which generates an imbalance of oxygen supply and demand. This injury is paradoxically prevented by adding the mitochondrial electron transport inhibitors rotenone or antimycin to the perfusion media.