The main purpose of basic clinical training for housestaff is to acquire the ability to be a primary physician who can properly manage acute medical problems, develop intimate bonds with patients, and provide them with continuous care. We emphasize the importance of training in the office, clinic, or patients' homes. Although residents have so far spent most of their clinical rotations in an inpatient setting, a training program that devotes substantial time to ambulatory care is indispensable to improve basic clinical training in primary care medicine.

BACKGROUND: GM1 ganglioside-bound amyloid beta-protein (GM1/A) has been reported to be involved with senile plaque formation in Alzheimer disease. METHODS: To investigate the binding of major gangliosides on senile plaques and neurofibrillary tangles of Alzheimer disease-specific pathology, we developed four monoclonal antibodies -- GM1, GD1a, GD1b, and GT1b -- employing the hydridoma technique, and applied them for immunohistochemical staining at the frontotemporal neocortex and hippocampus of Alzheimer disease brains and age-matched control brains. RESULTS: Moderate immunopositivity for GM1 and GD1a was noted on the senile plaques and neurofibrillary tangles. Mild immunopositivity for GD1b and GT1b on neurofibrillary tangles was noted. Strong GD1b immunopositivity was observed on a few neurons and neurites. Strong immunopositivity for GT1b, and moderate immunopositivity for GM1 and GD1a were noted on reactive astrocytes. CONCLUSIONS: These observations suggest that GM1 and GD1a may be involved in the formation of senile plaques as well as neurofibrillary tangles in Alzheimer disease brains.
Alzheimer Disease* ; Amyloid beta-Peptides ; Antibodies, Monoclonal ; Astrocytes ; Brain* ; Gangliosides* ; Hippocampus ; Immunohistochemistry ; Neocortex ; Neurites ; Neurofibrillary Tangles ; Neurons ; Pathology ; Plaque, Amyloid