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PubMed1991

Evaluation of patients treated for pathological gambling in a combined alcohol, substance abuse and pathological gambling treatment unit using the Addiction Severity Index.

Seventy-two pathological gambling patients were followed-up after treatment in a combined alcohol, substance abuse and compulsive gambling treatment program. The Addiction Severity Index (modified for use with pathological gamblers) was used to evaluate the effectiveness of treatment. Patients reduced their intake of alcohol, other drugs and their gambling as well as improved in legal, family/social, and psychological functioning. There was a trend for improvement in medical condition and no net change in employment functioning. The study supports the idea that combined treatment is an effective way of dealing with patients whose gambling problems are discovered when they enter treatment for another addiction, as well as for patients whose initial complaints include pathological gambling, with or without additional problems.

Adult↗
PubMedDate not supplied

Hippocampal pathology reflects memory deficit and brain imaging measurements in Alzheimer's disease: clinicopathologic correlations using three sets of pathologic diagnostic criteria.

Neurofibrillary tangles (NFT), neuritic plaques and amyloid load were quantified in sections of the hippocampus at the level of the lateral geniculate body in 41 consecutive cases fulfilling pathological criteria for diagnosis of Alzheimer's disease (AD) and coming to autopsy after longitudinal study during life. A strong correlation was found between NFT density in the hippocampus and cognitive impairment scores obtained shortly before death, particularly with scores of memory impairment. Weaker and less consistent correlations were found for hippocampal neuritic plaques and amyloid load with cognitive/memory deficits. No significant correlations were found between hippocampal pathology and either age of onset or disease duration. All three measures of hippocampal pathology were inversely correlated with the minimum medial temporal lobe (MTL) width, a measure of the MTL atrophy made from temporal-lobe-oriented X-ray computed tomography scans performed during life; the strongest correlation being between atrophy of the MTL and NFT density in the hippocampus.

Alzheimer Disease↗
PubMed1997

Comparison of extrapyramidal features in 31 pathologically confirmed cases of diffuse Lewy body disease and 34 pathologically confirmed cases of Parkinson's disease.

OBJECTIVE: To compare the extrapyramidal features of pathologically confirmed cases of diffuse Lewy body disease (DLBD) and Parkinson's disease (PD). BACKGROUND: The proportion of pathologically confirmed cases of DLBD diagnosed clinically as PD is as high as 88%. Few papers focus specifically on the extrapyramidal features of DLBD. Further characterization of these features might facilitate antemortem diagnosis, in particular, distinguishing DLBD from PD. METHODS: Review of prospective and retrospective clinical data on a large series of pathologically diagnosed cases of DLBD (N = 31) and PD (N = 34) seen between 1984 and 1995 at Columbia-Presbyterian Medical Center or the University of Rochester. RESULTS: Those with DLBD had an older mean age of onset (67.9 years) than PD (62.0 years) (z = 6.5, p < 0.0001). Rest tremor was more common in PD (85.0%) than DLBD (55.0%) (chi 2 = 4.3, p = 0.038). Myoclonus was more common in DLBD (18.5%) than PD (0%) (Fisher's p = 0.021). There were no differences in rigidity, bradykinesia, dystonia, or gaze palsies. Clinical response to levodopa may have been more common in PD (100%) than DLBD (70.0%) (Fisher's p = 0.059). The occurrence of any one of four clinical features (myoclonus, absence of rest tremor, no response to levodopa, or no perceived need to treat with levodopa) was 10 times more likely in DLBD than PD (odds ratio = 10.29, 95% confidence interval = 2.58-41.11). CONCLUSIONS: We demonstrated that several clinical features distinguish DLBD from PD. These features, in combination with reported differences in cognitive and psychiatric manifestations, may be used for diagnostic purposes in distinguishing DLBD from PD in prospective longitudinal cohort studies of DLBD.

Aged↗
PubMed1999

German uranium miner study--pathological and molecular genetic findings. German Uranium Miner Study, Research Group Pathology.

Uranium miners of the former Wismut company in Germany form the largest cohort of workers exposed to (222)Rn and dust in the world. The German Uranium Miner Study, Research Group Pathology, is evaluating the central pathology archive of the Wismut company. The main tasks of our study are pathological-anatomical and molecular genetic investigations of 28,975 autopsy cases and the evaluation of mining pollutants in the lungs by neutron activation analysis. As part of an observer agreement study, lung tumors are classified according to the WHO/IASLC classification and nontumorigenic lung disorders are registered. Lung tumors were analyzed for the presence of a proposed radon-specific mutation in the TP53 gene (formerly known as p53). Interim results are: (a) In the years 1957 to 1965, a high rate (69%) of small cell carcinomas was found which had declined to 34% by 1990. (b) The percentage of the deceased who suffered from silicosis is not higher in the group of lung tumors than in other tumor groups or the nontumor group. (c) The hypothesis of a radon-characteristic hotspot mutation in the TP53 tumor suppressor gene is not supported by our investigations. (d) Neutron activation analysis demonstrates that uranium, arsenic, chromium, cobalt and antimony can be found in tissue samples from the miners even when they had stopped working more than 20 years before death.

Genes, p53↗
PubMed2000

Do conventional pathologic features lose their prognostic significance following postoperative radiation therapy in pathologic stage I-II endometrial adenocarcinoma?

Recent data have suggested that conventional pathologic features (myometrial invasion (MI), grade, stage) lose their prognostic significance following postoperative radiation therapy (RT) in Stage I-II endometrial carcinoma. Our goal was to test this finding in a large cohort of women treated at our institution. Between 1980 and 1997, 188 Stage I (140) and II (48) endometrial adenocarcinoma patients received postoperative RT. RT consisted of pelvic RT (112), vaginal brachytherapy (36), or both (40). Clinicopathologic factors were evaluated as prognostic factors on both univariate and multivariate analyses. Factors correlated with recurrence on univariate analysis included MI (P = 0.05), grade (P = 0.07), lymphovascular invasion (LVI) (P = 0.001) and stage (P = 0.03). Multivariate analysis confirmed the significance of grade (P = 0.02), LVI (P = 0.001), and stage (P = 0.02). Conventional pathologic features do not lose their prognostic significance in pathologic Stage I-II endometrial adenocarcinoma patients following postoperative RT. These factors should continue to be used to identify women at risk for recurrence despite adjuvant RT. New prognostic markers are needed to better identify high-risk patients. Int. J. Cancer (Radiat. Oncol. Invest.) 90, 224-230 (2000).

Adenocarcinoma↗
PubMed1990

[Cytoskeleton--function and pathology: studies on the pathology of the intermediate filament cytoskeleton of liver cells].

Microfilaments, microtubules and intermediate filaments (IF) are major filamentous components of the cytoskeleton and play a role in the modulation of cell shape, in cellular movements, cellular stability, intracellular organisation as well as cell-to-cell and cell-to-stroma interactions. Particular interest was concentrated in the last few years on IF because of their cell type-specificity and, consequently, their suitability as cell markers in diagnostic pathology. Despite their apparent stability, IF are dynamic structures which may be modified under pathologic conditions. In recent years, pathologic alterations related to the IF cytoskeleton have been described in a diversity of chronic and degenerative disorders, including alcoholic hepatitis and neurologic diseases (e.g. M. Alzheimer, M. Parkinson). Our studies were particularly devoted to the elucidation of the pathogenesis of severe alcoholic liver injury (alcoholic hepatitis), which is associated with inflammation, liver cell degeneration and necrosis and morphologically characterized by the appearance of cytoplasmic hyaline inclusions (i.e., Mallory bodies). In the present review morphologic, immunologic and biochemical studies on nature and pathogenesis of Mallory bodies are summarized. Moreover, similarities between Mallory bodies and other cytoskeleton-related inclusion bodies suggest common routes of pathogenesis. Consequently, studies along these lines may not only lead to the understanding of mechanisms involved in alcoholic injury but may also provide information on general principles of cell damage as well as on regulation and function of the IF cytoskeleton.

Animals↗
PubMed1989

[The correlation between preoperative pathologic diagnosis of a biopsy specimen and postoperative pathologic diagnosis of a tissue specimen involving colorectal cancer patients].

An endoscopic biopsy was performed on specimens taken from 374 patients with a large bowel cancer, who had received a colo-rectal resection between 1980 and 1984. An average of three to four biopsy specimens was taken from each patient. The pathological diagnosis of these specimens revealed a carcinoma with an identifiable pathological classification in 280 patients (74.9%), a carcinoma without an identifiable classification in 54 (14.4%), a suspect cancer in 7 (1.9%), and no sign of a cancer in 33 (8.8%). The diagnosis of the 33 cases in which no cancer was detected were adenoma in 11 patients, inflammation in 8, necrosis in 1, and no clear pathological determination in 11. The correspondence rates between a biopsy specimen and a tissue specimen diagnoses were 57.9% in a well differentiated adenocarcinoma; 77.4% in a moderately differentiated adenocarcinoma; 85.5% in a poorly differentiated adenocarcinoma; and 100% in a mucoid carcinoma.

Adenocarcinoma↗
PubMed1989

[Characterization of the pathology of lactating cows based on the level of lactation. Principal factors in the variation and typing of pathologic profiles of lactation].

The health disturbances investigated were observed during a long-term trial (six years) conducted at an experimental station located at 1,100 m elevation. The study dealt with 487 lactations involving 190 cows of the Montbéliarde and French Friesian breeds, which produced on average 4,200 kg milk per lactation. The disturbances concerned 59% of monitored lactations, with a mean incidence of 2.1 disturbances per lactation. Lameness and mastitis accounted respectively for 52 and 24% of the clinical affections. Pathology was significantly influenced by breed, basic diet (hay or grass silage), concentrate quantities, lactation rank and year. The authors describe a method permitting an independent analysis of the effects of lactation stage and of season on mastitis and lameness frequency, by limiting the biases due to grouping of calvings and to culling. The study of lactations affected by several pathological disturbances shows that the different types of affections recorded are mutually independent but that successive occurrences of the same affection are not. On the basis of these results, the authors have proposed to globally characterize the "pathological profiles" of lactations.

Animals↗
PubMed1986

[Continuing eco-pathological survey: 5. Demonstration of pathologic associations in dairy cow stock: individual data].

The calculation of pathological association ratio (or relative risk) from two ways contingency tables, allowed to show numerous interrelationships between diseases of 1,205 dairy cows. The analysis concerns the animal during productive life, the lactation (all lactation mixed), a particular one (1st, 2nd, 3rd and more) and the beginning of productive life of cow (three first lactations). The relationships are discussed according to the level of calculation (animal, lactation, or beginning of life). There is some triangular relations: calving trilogy (dystocia-stillbirth-retained placenta), infectious trilogy (foul of the foot-metritis-mastitis), metabolic trilogy (appetite disorders-ketosis-digestive disorders), foot disorders trilogy (lameness-non infectious diseases of foot-foul of the foot). These pathological groups seem to depend from common risk factors (climate-feeding-cowshed hygiene-control of heat-age-culling policy-genetic factors-anatomical or physiological predisposition, animal size...), but, numerous interactions between groups are also shown, leading to consider pathology in farm like a complex entity.

Age Factors↗
PubMed1986

[Continuing eco-pathological survey: 9. Influence of the level of production on the pathology of the dairy cow].

Observations are made, during the Eco-Pathological Survey (EEPC), about six main clinical diseases of the dairy cow in the aim of studying the relationships between the milk yield level, the milk fat content, and the susceptibility to the major pathological problems (mastitis, metritis, retained placenta, lameness, digital infections, milk fever). Lactations from Black-Pied cows (1,036) and from Red-Pied ones (Montbéliardes, Tachetées de l'Est) (203) are analysed, and breed and lactation number effects are assessed. As a general trend, disease incidence increases with milk yield. For cows in the 2nd lactation or more, maximum daily milk yield increases with increasing number of diseases occurrences during the lactation: cows free of the six studied diseases produce 28 kg vs 29.2 kg for females with one disease, 30.2 kg when two diseases occurred, 31.9 kg for three diseases or more (P less than or equal to 0.001). Mastitis, lameness and digital infections appear as diseases linked with "high yield" (risk threshold between 30 and 35 kg of maximum daily milk yield). The average milk fat content of the cows free of pathology is 1 to 3% higher compared with affected animals. Relationships between milk yield level and susceptibility to disease seem to be included in the definition of the dairy herd of the future.

Animals↗
PubMed1993

[Pathology of travelers in the Antilles. Role of imported metropolitan pathology].

A preliminary and retrospective review--with a southern perspective--of some traveller's pathologies, mostly imported, and leading to hospital admission in Guadeloupe (FWI). End stage patients (cancer, AIDS...) frequently travel for a last, "compassional" trip. Ischemic heart disease is the leading pathology imported from the mother country (France). As well as in diabetes or psychiatric illness, destabilization frequently occurs as a consequence of travel (jet lag). Compulsive tennis plus dehydration cause the very common stone passage of nephrolithiasis. Concern is growing for heroin withdrawal syndrome or cocaine (crack)-abuse, and for supply for rare and expensive anticancer, antigraft rejection or antinfective (AIDS) agents. Much more familiar to us are photodermatitis, larva migrans, dengue, or ciguaterra, locally acquired. On the other hand some pathologies are quite "exotic" to us: Kaposi sarcoma, Lyme, or Behçet disease, familial mediterranean fever, brucellosis.

Epidemiology↗
PubMed1997

[Clinico-pathological significance of the immunostaining of myosin heavy chain isoforms in pathological human skeletal muscle].

Expression of the four myosin heavy chain isoforms (fast-twitch, slow-twitch, neonatal and embryonal isoforms) was immunohistochemically observed in 500 biopsied limb muscles of neuromuscular disorders. Fast-twitch isoform was expressed in type 2A, 2B and pathologic 2C fibers. Slow-twitch isoform was expressed in type 1 and 2C fibers. Embryonic isoform was expressed in regenerating type 2C fibers of active myopathies such as Duchenne dystrophy and polymyositis. Expression of neonatal isoform, which was longer positive than that of embryonic isoform, was noted in regenerating fibers, denervated fibers and highly atrophic fibers in chronic myopathies of limb-girdle dystrophy and myotonic dystrophy. In conclusion, the immunostaining of MHC isoforms are useful to make a clinico-pathological diagnosis to determine the stages in evolution of regeneration or degeneration of pathologic muscle fiber per se.

Humans↗
PubMed2003

[Histopathological diagnosis of Barrett's mucosa and associated neoplasias. Results of a consensus conference of the Working Group for "Gastroenterological Pathology of the German Society for Pathology" on 22 September 2001].

There are a number of difficulties regarding the diagnosis of Barrett's mucosa and the varying grades of neoplasia that may be associated with it. It was therefore the aim of a consensus conference of the "Working Group for Gastroenterological Pathology within the German Society of Pathology" to achieve standardization regarding the following issues: definition and diagnostic criteria for Barrett's mucosa and its discrimination from intestinal metaplasia of the cardia, diagnostic criteria for intraepithelial neoplasia, number of biopsies necessary to establish the diagnosis, significance of additional immunohistochemical and/or molecular biological methods as well as importance of a second opinion in the diagnosis of intraepithelial neoplasia.

Barrett Esophagus↗
PubMed2003

Self-instructional "virtual pathology" laboratories using web-based technology enhance medical school teaching of pathology.

Second-year medical students have traditionally been taught pulmonary pathophysiology at the University of California-Los Angeles (UCLA) School of Medicine using lectures, discussion groups, and laboratory sessions. Since 1998, the laboratory sessions have been replaced by 4 interactive, self-instructional sessions using web-based technology and case-based instruction. This article addresses nature of transformation that occurred from within the course in response to the infusion of new technologies. The vast majority of the course content has been digitized and incorporated into the website of the Pathophysiology of Disease course. The teaching histological slides have been photographed digitally and organized into "cases" with clinical information, digital images and text, and audio descriptions. The students study the materials from these cases at their own pace in 2 "virtual pathology" laboratory, with a few instructors supervising the on-site sessions. The students discuss additional cases available on the website in 2 other laboratory sessions supervised by a pulmonologist and a pathologist. Marked improvement in student participation and satisfaction was seen with the use of web-based instruction. Attendance at laboratory sessions, where the students had previously been required to bring their own microscopes to study histological slides at their own pace, increased from approximately 30% to 40% of the class in previous years to almost 100%. Satisfaction surveys showed progressive improvement over the past 4 years, as various suggestions were implemented. The value of web-based instruction of pathology at the UCLA School of Medicine is discussed.

California↗
PubMed2000

Impact of the Armed Forces Institute of Pathology Radiologic Pathology Course on radiology resident performance on the ACR In-Training and ABR written Examinations. American College of Radiology. American Board of Radiology.

RATIONALE AND OBJECTIVES: The purpose of this study was to assess resident scores on the American College of Radiology (ACR) In-Training Examination and on the written American Board of Radiology (ABR) Examination relative to attendance at and timing of the Armed Forces Institute of Pathology (AFIP) Radiologic Pathology Course. MATERIALS AND METHODS: A survey of 200 radiology residency program directors requested the type of residency program, whether the program sent residents to the AFIP course, dates of AFIP attendance for individual residents, percentile scores of residents on the ACR examination from 1995 through 1998, and ABR examination scores for 1997. Scores were analyzed before and after AFIP attendance and also temporally for examinations during or after AFIP attendance. Improvement in percentile scores for residents undergoing the ACR examination while attending the AFIP were compared with scores of matched residents from their programs who had not attended. RESULTS: Thirty-six (18%) program directors responded, providing data on 619 residents who underwent the ACR examination, ABR examination, or both. No significant improvement was found between pre- and post-AFIP ACR Examination scores for residents at university or military programs. There were statistically significantly improved scores for residents at community programs (mean percentile improvement, 8.1 points; P = .0064). Residents who underwent the ACR examination during the AFIP course improved their scores by 10.7 percentile points compared with matched residents who had not attended the AFIP course (P = .041). CONCLUSION: Residents undergoing the ACR examination while attending the AFIP improve their percentile scores more than residents who have not attended the AFIP.

Curriculum↗
PubMed1982

A program of training in chemical pathology for residents in pathology.

We have developed a new program of instruction in chemical pathology for residents in pathology. The major features that differentiate this program from its predecessor are: first, an emphasis on principles rather than technical details of biochemical analysis; second, didactic instruction and practical experience in laboratory management and administration; and, third, instruction in interpretation and selection of laboratory tests. The organization, content, instructional approaches and learning objectives are described.

California↗
PubMed1987

Megatrends in pathology practice: implications for residency training. Ninth Conference for pathology residency program directors--a summary.

The participants at the Ninth Conference for Pathology Residency Program Directors clearly identified the important trends, the problems, and the opportunities now confronted by the specialty of pathology. Equally important, the speakers identified changes that should be incorporated into residency programs if we are to provide the training and education for practice in a changing medical environment. Evaluations of the program by the participants indicated it had been a valuable conference and it should be maintained as a part of each annual American Society of Clinical Pathologists/College of American Pathologists Fall Meeting.

Delivery of Health Care↗