Introduction: Art has played a pivotal role in the understanding and teaching of human anatomy for centuries, and the use of drawing as a teaching tool had been well documented. With the global modernization of medical education, the teaching of anatomy has diminished. We present a model of teaching anatomy through drawing, and assess its efficacy in improving students' retention of anatomical knowledge. Methods: We designed a series of four anatomy drawing workshops (upper limb, lower limb, thorax, and head & neck) for students studying medicine, dentistry, and allied science degrees. Students were only allowed to attend one of the four workshops. Workshops were delivered by medically-qualified anatomy demonstrators using a combination of "whiteboard drawing demonstrations" and "cadaveric demonstrations and drawings." A pre-and post-anatomy test consisting of 12 multiple choice questions (MCQs) and quantitative self-score questionnaires on "confidence in drawing anatomy" and "anatomical knowledge" were completed. Qualitative questionnaires on "reasons for attendance," "skills learnt," and "what improvements could be made" were also completed. Results: A total of 49 students attended the drawing workshops, the majority studied medicine (58.3%). Twenty-seven pre-and post-anatomy MCQ tests were completed, and demonstrated a significant mean improvement of 1.11 points (p = 0.001). "Confidence in drawing anatomy" and "Knowledge of anatomy" significantly improved by 43.2% and 41.4% (p = 0.001), respectively. Only 13% of students used drawing as their "main learning tool." The most commonly reported barrier in using drawing as a revision tool was "time constraints." Qualitative feedback was excellent. Students suggested that these workshops should be integrated into the core anatomy curriculum. Conclusion: Learning anatomy through drawing, is not only more engaging and fun, encourages students to visualize and better understand anatomical planes, thus, allowing them to retain anatomical knowledge easier. The two-part nature of our sessions enabled students to apply and translate the more conceptual knowledge from the "whiteboard drawing demonstration" onto the more "real-life" structures in the "prosection and cadaveric demonstration." With the decline in anatomy teaching throughout universities, most prominently dissection, drawing may offer an alternative and economical way of training students to learn anatomy.

In an attempt to document a broader spectrum of the benefits of their pharmaceutical products, drug companies increasingly seek to include productivity claims in their promotional campaigns. We describe the existing regulatory framework of the Food and Drug Administration (FDA) for considering productivity claims, distinguishing between the traditional "substantial evidence" standard and the "competent and reliable scientific evidence" standard. But the notion of competent and reliable scientific evidence may itself be problematic, even when it is the appropriate regulatory standard, because there exists no consistent measurement approach across diseases, workplaces, jobs, and worker capabilities that is widely accepted in this emerging area of health outcomes research. We examine the various measurement approaches that have been used to quantify the impact of illness and its treatment on workplace productivity, and we describe some of the shortcomings associated with each alternative. This discussion highlights the possible difficulties faced by the FDA in reviewing productivity-based promotional claims. Finally, we suggest possible strategies for furthering this field of investigation.

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CorrespondenceStudies on the laryngeal mask: first, learn the art .4.1.J. Brain FFARCS Aspiration pneumonia and the laryngeal mask airway P.L. Riddell, FFA R C S B. Philpott, FFARCS A .I. J . Bruin, FFA R C S J.R. Krapez, FFARCS R . M . Grifin, FFARCS and I.S. Hatcher, M B , BS Aspiration and the laryngeal mask airway N . Koehli, FFARCS Son with lumikre for cardiovascular monitoring A . Gilston, FFARCS Midazolam withdrawal syndrome 1. McLellan, FFARCS and E. Douglas, RGN Failure of an Ohmeda Oxicap 4700 S.P. W. Spiers, FCAnaes and R. W. Harris, FCAnues 'Finger-painting' and the pulse oximeter J.R. Sneyd, FFARCS Research difficulties for junior anaesthetists T.M. Akhtar, FFARCSI 'Hazards' of oxygen therapy during spinal

Chromosomal rearrangements resulting in novel fusion genes are among the most prevalent form of genetic alterations known in cancer, and numerous examples exist in both adult and childhood malignancies. To date, however, none have been reported in pediatric high-grade glioma (pHGG), so we have undertaken to search for novel structural rearrangements using three distinct techniques. Firstly, we took a candidate approach and screened a series of 83 pHGG for the fusion previously described in adult glioblastoma between PDGFRA and KDR (VEGFR2) at 4q12. Using RT-PCR and sequencing, we identified the second reported instance of KDR:PDGFRA in a single case of glioblastoma (age 1.2 years). Next, we applied the iCNA algorithm to identify copy number aberrations with intragenic breakpoints using Affymetrix 500K SNP data from a cohort of 100 pHGG, identifying two candidates arising from genomic amplification and intrachromosomal rearrangement in an analogous mechanism to KDR:PDGFRA. We finemapped the breakpoints using custom Agilent oligonucleotide arrays and characterized the fusions DHX57:MAP4K3 (2p22) and CSGALNACT2:RET (10q11) in cases of anaplastic astrocytoma (2 years) and recurrent glioblastoma (12.8 years), respectively. Finally, we sequenced the entire genomes of five pediatric glioma cell lines at .30× coverage using the Illumina HiSeq2000 platform, and screened for rearrangements using the BreakDancer (BD) package. We identified a median of 165 intragenic structural variants per genome that were filtered based on BD confidence score, number and orientation of reads and by visual inspection using IGV software. Candidate fusions being systematically validated and screened in our pHGG cohorts include interchromosomal rearrangements resulting in TULP4:RPTOR (t6;17 -SF188), GORASP2:CDADC1 (t2;13 -KNS42) and C15ORF57:CBX3 (t15;7 -UW479). These data highlight the presence of hitherto unrecognized fusion genes in pHGG which may play important roles in the unique biology of the tumors as well as provide excellent candidates for novel therapeutic strategies. Recently, we and others identified the first recurrent somatic mutations in a histone gene (H3F3A) in one-third of pediatric glioblastoma (pedGBM), the most devastating brain tumor in childhood. The observed mutations in H3F3A, coding for the non-canonical histone variant H3.3, led to amino acid substitutions at two critical residues of the histone tail (K27M and G34R), at or near sites of important post-translational modifications. Furthermore, we have shown that pedGBMs carrying K27M or G34R mutations are characterized by distinct gene expression and DNA methylation profiles. This clearly shows that different signalling pathways predominate in K27M or G34R mutated tumors. To address the functional impact of these different H3.3 mutations in more detail, we generated GBM cell lines stably expressing either K27M or G34R mutated H3.3. K27M mutated cells show a reduction of trimethylated H3K27 (H3K27me3) as indicated by western blot. Using immunohistochemistry on a tiss...