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Papillary urothelial neoplasm of low malignant potential: evolving terminology and concepts.

PURPOSE: The most controversial aspect of the new WHO 2004/ISUP classification system is the creation of the PUNLMP diagnostic category. We discuss PUNLMP tumors and the WHO 2004/ISUP classification system with an emphasis on tumor morphology and heterogeneity, recurrence and progression rates, tumor genetics, interobserver variability and the usefulness of biomarkers and molecular diagnostic techniques for grading bladder tumors. MATERIALS AND METHODS: A literature search using PubMed was performed. All relevant literature concerning PUNLMP and the WHO 2004/ISUP grading system for urothelial neoplasms was reviewed. RESULTS: The new WHO 2004/ISUP classification reflects work in progress. Low malignant potential terminology may not reflect the true biological behavior of these tumors. Additionally, interobserver variability in making a diagnosis of PUNLMP is high despite detailed histological criteria. Urine cytopathology in the context of the WHO 2004/ISUP classification does not appear to effectively discriminate PUNLMP from low grade carcinoma. CONCLUSIONS: For practical purposes patients with PUNLMP should be treated similarly to patients with low grade, noninvasive urothelial carcinoma. It is our hope that recent advances in the molecular grading of these tumors may eventually supplant traditional morphological classification, allowing a more precise and objective assessment of the biological potential of these tumors.

Carcinoma, Papillary↗

Renal dysgenesis and cystic disease of the kidney: a report of the Committee on Terminology, Nomenclature and Classification, Section on Urology, American Academy of Pediatrics.

We believe that the confusion regarding abnormal renal development could be reduced by more precise terminology. Therefore, we suggest precise definitions for dysgenesis, hypoplasia, dysplasia, hypodysplasia, aplasia and agenesis of the kidney. We suggest the term reflux nephropathy be a generic label for any instance of abnormal renal morphology (gross or microscopic) associated with vesicoureteral reflux. Hypoplasia and hypodysplasia can be subclassified on the basis of associated urological criteria. There have been many previous attempts to classify cystic disease of the kidney but none has been accepted collectively by pathologists, urologists, nephrologists and radiologists. On the basis of known patterns of inheritance, a classification is outlined in which renal cystic disease is divided into 2 major groups: genetic and nongenetic. Each entity is discussed.

Classification↗

Perforator flap terminology: update 2002.

The first terminology consensus on perforator flaps, reached in 2001, was reviewed and further simplified following the Sixth International Course on Perforator Flaps.

Humans↗

Hippocampal terminology: concepts, misconceptions, origins.

The mammalian hippocampus is certainly one of the best investigated brain regions. It fascinates neuroscientists particularly because of its important role in memory. The names for the various parts of the hippocampal formation were created in the course of the first thorough explorations of human brain anatomy. The present, internationally agreed terminology reflects an unfortunate muddle that has been going on for several hundred years. Not surprisingly, even today the origins of some of the names are not always given correctly. It is generally accepted that the Italian anatomist Arantius was the first to apply the term 'hippocampus' to part of that region in the human brain. To later authors, however, this name appeared more or less enigmatic and they proposed various other terms. Yet careful reading of the entire original text of Arantius leads to the conclusion that it was not the hippocampus in our modern terms but the dentate gyrus which he compared to a little sea horse or a silkworm.

Anatomy↗

Moving toward uniform reporting and terminology.

Researchers interested in performing research on prehospital cardiac arrest should carefully review the presentations from the session "Moving Toward Uniform Reporting and Terminology." Although each presentation concentrates on specific research topics, taken together they suggest the next evolutionary steps we should take to conduct such research. We will base these further steps on the following insights. First, all future articles on prehospital cardiac arrest must share a common nomenclature and template for reporting outcomes. The Utstein style has not solved this problem completely, but it is the critical first step. Over the coming years, we must, through continued use, progressively refine the Utstein style. Second, we can no longer depend on research that comes from a single EMS system. Although we have gained important insights from such studies in the past, our expectations of greater validity and generalizability are rising and pushing us toward multicenter, cooperative studies. The International Brain Resuscitation clinical trials and the numerous studies on thrombolytic therapy demonstrate the directions we must head. Third, we must abandon our narrow focus on the pre-hospital experience. Although some studies have avoided this problem, the preponderance of clinical studies on prehospital cardiac arrest fails to gather information on the prearrest condition of the patient, the actual decisions and action taken around the event (witness Kellermann's discussion of death criteria and rules for stopping resuscitation efforts), and the clinical experience after successful resuscitations. Fourth, we can no longer be satisfied with simple statistics on dichotomous (yes/no) survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Data Collection↗

[Defining AIDS terminology. A practical approach].

Since the appearance of AIDS, the study of this disease has generated a large amount of information and an extensive related vocabulary comprised of new terms or terms borrowed from other scientific fields. The urgent need to provide names for newly described phenomena and concepts in this field has resulted in the application of terms that are not always appropriate from the linguistic and scientific points of view. We discuss the difficulties in attempting to create adequate AIDS terminology in the Spanish language, considering both the general problems involved in building any scientific vocabulary and the specific problems inherent to this activity in a field whose defining illness has important social connotations. The pressure exerted by the predominance of the English language in reporting scientific knowledge is considered, and the inappropriate words most often found in a review of current literature are examined. Finally, attending to the two most important criteria for the creation of new scientific terms, accuracy and linguistic correction, we propose some well thought-out alternatives that conform to the essence of the Spanish language.

Acquired Immunodeficiency Syndrome↗

The conceptual basis of ethnic group terminology and classifications.

"Ethnic group" is a problematic variable in health-related research. While self-identification is now widely accepted as the appropriate mode of assignment, the impracticalities of a free response in the collection of ethnic group data mean that categorisation into a limited set of choices must take place. The substantial and increasing number of persons in minority ethnic groups who identify through non-standard responses emphasises the need to develop classifications that accommodate salient vernacular terminology. The use of informants in cognitive settings and the monitoring of open-ended responses appear to offer the best way of determining which group labels to employ. The recommended approach addresses the research priorities for accurate, consistent, and high quality data and is also responsive to the dynamic nature of ethnic group and the growing ethnic diversity of the population.

Data Collection↗

Recommended terminology and advances in the systematics of the Cyathostominea (Nematoda: Strongyloidea) of horses.

Terminology for common names for the Tribe Cyathostominea (cyathostomins), and disease caused by the nematodes (cyathostominosis), were recommended to replace the previously used names cyathostomes and cyathostomosis, which are ambiguous, inaccurate or synonymous, by the Third Internal Workshop on the Systematics of Cyathostominea of Horses, held in Stresa, Italy, 28 August 2001. The progress by this international working group at three workshops is reviewed briefly and a list of publications is provided. Included are an annotated checklist by genus and species of 93 species level names and the recognition of 52 species, redescriptions of seven species, and the description of one new species. Upon petition by workshop participants, the International Commission on Zoological Nomenclature placed Cyathostomum tetracanthum Mehlis, 1831 on the "Official List of Specific Names in Zoology", ending more than a century of controversy over the names of cyathostomins. Some progress is described in molecular and morphological systematics and in the development of diagnostic molecular probes. A revised identification key is being prepared to the 52 species of the Tribe Cyathostominea.

Animals↗

A novel terminology and dissemination theory for a subgroup of intrathoracic extrapulmonary hydatid cysts.

Chest wall, mediastinal, pericardial, myocardial, lobar fissure and pleural locations of the hydatid cysts are referred to be intrathoracic extrapulmonary cysts. In this report a 20-year-old male patient had a liver dome cyst, which was opened into the diaphragm and caused diaphragmatic hydatid cysts. The scoleces have probably been transported by diaphragmatic lymphatics into the subpleural location and then hydatid disease has been disseminated via parasternal lymph nodes anteriorly and intercostal lymph nodes posteriorly towards cupola of the thorax. With regard to this localization, we propose a novel terminology as 'intrathoracic extrapleural hydatid cyst' and we hypothesize a novel dissemination theory for the hydatid cysts via diaphragmatic lymphatic drainage.

Adult↗

So called "fibro-osseous lesions" of tumorous origin. Biology confronts terminology.

The terms "fibro-osteo-cemental lesions" or "ossifying" and "cementifying fibromas" are confusing and should be discarded and replaced by clear and distinct terminology based on clinically, radiologically and histopathologically observable and reproducible characteristics. Histogenetic features and biological potential rather than tumour tissue products alone should be regarded as the basis for nomenclature. A classification of "fibro-osseous lesions" and three tumorous entities which have been defined by the terms "periodontoma", "psammous desmo-osteoblastoma" and "trabecular desmo-osteoblastoma" are presented and illustrated. These proposed entities go some way to bridge the gap between clinical diagnosis on the one hand and morphological and descriptive diagnosis on the other.

Bone and Bones↗

Current terminology and diagnostic classification schemes.

This article reviews the current terminology and classification schemes available for temporomandibular disorders. The origin of each term is presented, and the classification schemes that have been offered for temporomandibular disorders are briefly reviewed. Several important classifications are presented in more detail, with mention of advantages and disadvantages. Final recommendations are provided for future direction in the area of classification schemes.

Humans↗

The use of a medical dictionary for regulatory activities terminology (MedDRA) in prescription-event monitoring in Japan (J-PEM).

The Medical Dictionary for Regulatory Activities Terminology (MedDRA) version 2.1 (V2.1) was released in March 1999 accompanied by the MedDRA/J V2.1J specifically for Japanese users. In prescription-event monitoring in Japan (J-PEM), we have employed the MedDRA/J for data entry, signal generation and event listing. In J-PEM, the lowest level terms (LLTs) in the MedDRA/J are used in data entry because the richness of LLTs is judged to be advantageous. A signal is generated normally at the preferred term (PT) level, but it has been found that various reporters describe the same event using descriptions that are potentially encoded by LLTs under different PTs. In addition, some PTs are considered too specific to generate the proper signal. In the system used in J-PEM, when an LLT is selected as a candidate to encode an event, another LLT under a different PT, if any, is displayed on the computer screen so that it may be coded instead of, or in addition to, the candidate LLT. The five-level structure of the MedDRA is used when listing events but some modification is required to generate a functional event list.

Adverse Drug Reaction Reporting Systems↗

The terminology of larval cestodes or metacestodes.

The terminology associated with the nomenclature of larval or metacestodes is reviewed as well as the various morphological and developmental characters used to define different types of larval cestodes. Based on a review of the literature, the key characters differentiating the types of larval cestodes are the presence of a primary lacuna and the invagination/retraction of the scolex. The presence of a cercomer and of a bladder-like enlargement of the larval cestode were considered to be useful secondary characteristics. Using these characters, six basic types of larval cestodes were identified: the procercoid, an alacunate form which cannot develop further until ingested by a second intermediate host; the plerocercus, an alacunate form with a retracted scolex; the plerocercoid, an alacunate form with an everted scolex; the merocercoid, an alacunate form with an invaginated scolex; the cysticercoid, a lacunate form with a retracted scolex; and the cysticercus, a lacunate form with an invaginated scolex. The diversity of larval types within the broad classifications of cysticercoid and cysticercus can be differentiated by the use of appropriate prefixes. Deficiencies in knowledge of specific types of larval cestodes are identified and further avenues of research are indicated.

Animals↗

Terminology of the sucker-like organs of the scolex of trypanorhynch cestodes.

The literature associated with descriptions and definitions of the sucker-like attachment organs in trypanorhynchs, termed either bothria or bothridia, is reviewed. There are descriptions of 14 trypanorhynch species representing 10 families. In none of these trypanorhynchs was a membrane separating the attachment organ from the scolex parenchyma described, one of the definitions used to distinguish bothria from bothridia. Transmission electron microscopy of the bothria of the trypanorhynch species Nybelinia queenslandensis Beveridge & Jones, 1998 (Tentaculariidae) and Otobothrium mugilis Hiscock, 1954 (Otobothriidae) also failed to show any membranous structure separating the surface of the attachment organ from the cestode parenchyma. The sucker-like attachment organs of trypanorhynchan cestodes appear, therefore, to be bothria rather than bothridia. As a result, changes in the terminology of related features of the scolex are proposed here. Henceforth, the pars bothridialis should be referred to as the pars bothrialis and the bothridial pits should be referred to bothrial pits.

Animals↗

Secondary impingement in the shoulder. An improved terminology in impingement.

Non-traumatic shoulder pain in the overhead athlete is a diagnostic challenge. In the last decade shoulder arthroscopy and magnetic resonance imaging (MRI) techniques have extended our knowledge. Previously unknown pathologic changes in the glenohumeral joint have been demonstrated and it is recognized that impingement symptoms and instability are often related. Shoulder dysfunction in overhead athletes may be caused by shoulder instability. However, a possible instability in the shoulder is often "silent" and difficult to demonstrate by ordinary tests and has therefore by some been termed "functional instability". It is now thought that functional instability in the shoulder may lead to a vicious cycle involving microtraumata and attenuation of the capsular complex, and may eventually lead to shoulder pain. Changes in shoulder proprioception, measured by testing kinaesthetic sense and position sense, can be related to different pathologic changes in the shoulder, and sensory motor control may be an important factor for functional stability in the shoulder. MRI and arthroscopical findings in athletes with shoulder pain are changes in the glenoid labrum, the humeral head, the rotator cuff, biceps tendon and the capsular complex. However, these findings often present other clinical entities than impingement and are not always associated with instability. Clinically, there are tests that can objectively distinguish some of the pathological findings. However, we need more exact methods to further improve our clinical diagnoses of the painful shoulder. One of the keys could be an extended knowledge about the pathophysiology behind functional instability. This review focuses on an improved terminology in impingement based on the current knowledge of impingement and instability in the shoulder.

Adult↗

Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: examples from the child-clinical and pediatric psychology literatures.

Numerous recent attempts to identify mediated and moderated effects in child-clinical and pediatric research on child adjustment have been characterized by terminological, conceptual, and statistical inconsistencies. To promote greater clarity, the terms mediating and moderating are defined and differentiated. Recommended statistical strategies that can be used to test for these effects are reviewed (i.e., multiple regression and structural equation modeling techniques). The distinction between mediated and indirect effects is also discussed. Examples of troublesome and appropriate uses of these terms in the child-clinical and pediatric psychology literatures are highlighted.

Causality↗