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PubMed1976

Oral roentgenologic findings in a Norwegian urban population.

Orthopantomograms were taken of 111 subjects constituting a random sample of 35-year-old citizens of Oslo. The most frequent pathologic finding was marginal bone loss, which was found in seventy-one persons (64%). Fifty-one impacted and unerupted teeth in twenty-eight persons were seen, the third molars predominating. Ten retained roots were found in nine persons, and apical radiolucent areas were found on forty-four teeth in thirty-three persons. In addition to the pathologic findings, 101 endodontically treated teeth in fifty-five persons were observed.

Adult↗
PubMed1993

Prognostic utility of subcomponents of the borderline personality construct in bulimia nervosa.

We examined various components of the 'borderline personality construct' as predictors of initial response to treatment in 61 bulimic patients. At pre-treatment, a 'borderline/non-borderline' distinction was established using DSM III-R criteria, and other components of 'borderline' pathology ('borderline traits', object-relations disturbances, maladaptive defences and mood pathology) were assessed using self-report. Self-reported eating and psychiatric symptoms were obtained at initial and three-month evaluations. Using hierarchical regression analyses, we controlled effects of initial eating and psychiatric symptoms, and then evaluated various measures of the borderline construct as predictors of later symptom severity. Categorical borderline PD diagnoses were linked to poorer response on eating attitudes and symptoms, and fine-grained analyses indicated that this prognostic effect might be mediated by mood and object-relations disturbances. Findings therefore seemed to isolate specific subcomponents of borderline personality pathology that predicted poorer response on eating symptoms.

Adult↗
PubMed2006

Medical students' perceptions of pathology and the effect of the second-year pathology course.

To explore the perceptions of medical students regarding pathology and the effect of the sophomore pathology course, a questionnaire was given to second-year students from 5 different medical schools at the beginning and again at the completion of their pathology course. The questionnaire was given to students in the class of 1995 and then again for those in the class of 2002, with nearly 1,500 surveys collected over the study period. The survey included questions that sought to determine students' affinity for pathology, their understanding of the typical duties of a pathologist, and how they viewed pathology relative to other specialties and perceived positives and negatives of being a pathologist. Overall, the second-year pathology course had little effect on medical students' perceptions of pathology but did provide some increase in their understanding of pathology as a profession. Responses were in general stable when comparing the different classes. Those students interested in pathology emphasized the intellectual aspects of pathology although being less deterred by negative factors such as limited patient contact. In our sample of medical schools, the sophomore pathology course was ineffective at influencing students' perceptions of pathology. Furthermore, those students who are interested in pathology are drawn because of a perceived fit between their personalities and the perception of pathology as a solely scholarly and isolated specialty. Better education about the practice of pathology in the second year, and more importantly, continuing into the clinical years, is necessary to combat these misconceptions about pathology.

Adult↗
PubMed2004

Anthropological data in individualization of skeletal remains from a forensic context in Kosovo--a case history.

There are many reports relating to victims and mass graves in the former Yugoslavia. They emphasize the importance of creating local skeletal identification standards. In this paper we deal with the first mass grave examined since the Kosovo crisis started and discuss problems regarding the identification process, especially the coincidence of antemortem with postmortem data. Twelve persons out of 39 bodies were identified using interviews with relatives and correspondence of biological data with personal effects and/or documents. Previous pathology was of crucial importance in the identification of three persons.

Adult↗
PubMed1996

The Pathology of Medullary Carcinoma of the Thyroid: Review of the Literature and Personal Experience on 62 Cases.

The aim of the present review is to analyze the numerous pathological patterns of medullary carcinoma of the thyroid (MCT) and discuss the problems of differential diagnosis with other thyroid and nonthyroid tumors. In addition, morphological parameters and phenotypic features were related to the clinical outcome. The recent literature was reviewed and compared with the features of 62 MCTs observed at our institution. The most common patterns of growth are trabecular, alveolar and spindle cells, but MCT can mimic virtually all other primary thyroid tumors and some nonthyroid neoplasms. This heterogeneity has no proven implications for prognosis, but is of relevance for diagnostic purposes, as the differential diagnosis of MCT can be difficult in nonclassical cases. In agreement also with the literature data, no relationship between histopathological parameters and outcome was found in our series, although clinically aggressive tumors had a more advanced stage at presentation. Immunocytochemica demonstration of calcitonin is apparently the only valid criterion for a correct typing of MCT. Chromogranin A is an additional sensitive marker of MCT and parallels calcitonin expression in the majority of cases.

Journal Article↗
PubMed1994

Neurobehavioral outcome of children's mild traumatic brain injury.

Brain damage is underestimated as a public health and personal problem. The common belief in a good prognosis for childhood brain damage is unsubstantiated. It is based on lack of rigorous study and examiner satisfaction with a low response level. Occult brain trauma plagues victims into maturity. Above a rather low threshold of injury (even without focal neurologic findings), cognitive, personality, and adaptive dysfunctions are common and impairing. Child abuse signals were described. Brain lesions impair both matured functions and those expressed later. Dysfunctions were discussed for these neurobehavioral systems: consciousness, attention and tonic motor level; sensorimotor and body schema; neurophysiologic; cerebral personality; intelligence; memory; language; information processing; posttraumatic stress and mood; identity and insight; adaptivity in the community. Outcome evolves from complex pathologic, neurologic, anatomic, and personality parameters, the postinjury interval and child's age, the maturity and developmental trajectory of the function, social support, and emotional reaction to impairment. Assessment should study the entire range of functions, utilizing records, collaterals, observation, and qualitative and psychometric measurement. Complex, challenging, and ecologically relevant tasks are appropriate. There are several patterns of outcome: immediate permanent deficits; improvement through compensatory mechanisms, but with subclinical deficits; and initial progress with delayed expression (premature plateau of cognitive and personality maturity; physiologic developmental deficits). Confirmation of mild TBI may require several years of observation to determine late dysfunctions and deviation from preinjury or postinjury performance or expected level of development.

Behavior↗
PubMed1978

Perception of a non-ill participant in a mental health discussion.

Describing a mental patient's claim to sanity as symptomatic may increase the probability that others will assimilate non-ill behavior into a pathological framework. In two experiments subjects saw a simulated session of group therapy on videotape. Each videotape contained a therapist, four persons role-playing specific disorders, and one person acting normally. After receiving different instructions, all subjects were asked to categorize the five patients. In Exp. 1 no consistent conclusions were possible because only 2 of 59 subjects said the normal person was not ill. Exp. 2 avoided this "floor effect" by the videotape therapist's agreeing with the normal person's claim of not being ill. The subjects precautioned against believing claims of sanity were most likely to categorize the person exhibiting non-ill behavior. A second group of subjects were not precautioned against believing sanity claims. A third group of subjects, informed of one patient's non-illness, were most likely to differentiate the normal person from those portraying pathological behavior.

Attitude of Health Personnel↗
PubMed1988

[Delimitation of morbid and nonmorbid querulousness].

The differences are established in the manifestations and course of litigious-paranoid disorders of psychogenic personality-related origin and nonpathological querulousness. Pathologic litigiousness is characterized by a larger constitution-personality predisposition, lesser situational dependence and possibility of psychopathologic classification of querulous manifestations. An excessive intensity and length of querulousness, as related to the objective value of the psychogenesis, the more pronounced trend to litigiousness manifestations, progressive loss of their relation to situational cues, aggressive traits in behavior, are all characteristic of litigious-paranoid disorders. These and other features of litigious-paranoid disorders can be used as differential diagnostic factors in differentiating between pathologic and nonpathologic querulousness.

Antisocial Personality Disorder↗
PubMed2001

Histopathological findings of cardiac conduction system of 150 Finns.

One hundred and fifty heart specimens were collected from the cases submitted for autopsy in the Department of Forensic Medicine in the University of Turku in March-May 1995 and May-July 1996, respectively. The cardiac conduction system (CCS) of these hearts were examined in order to find out the histopathological changes in the CCS of Finnish persons and their forensic pathological significance. There were 94 males and 56 females. Almost all age groups were included. The results revealed that in most of the persons the fibrous tissue and fatty tissue in the CCS increased with aging. In about half of the persons, there was deposition of calcium in the central fibrous body, pars membranacea, and the top of the musculature in the interventricular septum. In seven cases, the atrioventricular node (AVN), His bundle (HB) or bundle branches (RBB, LBB) were compressed by the calcium deposition. Hemorrhage, inflammation, amyloidosis, tumor, fatty infiltration and developmental malformations were observed in 31 cases. Twenty-eight cases died of myocardial infarct, among them, no involvement of the CCS could be observed. The authors concluded that routine examination of the CCS is helpful for revealing diseases of the CCS and improving the quality of forensic pathological diagnosis.

Adult↗
PubMed2003

Depression and anxiety during isolation and radionuclide therapy.

The combination of a diagnosis of malignancy and hospitalization, isolation and radioactivity of a radionuclide therapy may have an important effect on the psychological equilibrium of patients and may hamper compliance and acceptability. We performed a psychiatric evaluation in order to study psycho-pathological manifestations and underlying personality related vulnerabilities. During radioisolation, 48 patients (24 male, 24 female; mean age 57.8 years) with a malignant (n=26) or non-malignant (n=22) pathology who needed isolation for radionuclide therapy, completed a series of questionnaires in order to assess anxiety (Spielberger State and Trait Anxiety Inventory; STAI), depression (Beck Depression Inventory; BDI), hopelessness (Beck Hopelessness Scale; BHS), personality characteristics (Temperament and Character Inventory; TCI) and coping strategies (Utrecht's Coping List; UCL). Compared to patients with low state anxiety, patients who experienced a high level of state anxiety showed higher levels of depression (t=-2.10; P=0.04) and hopelessness (t=-4.20; P=<0.001). Their personality was characterized by significantly higher scores on harm avoidance (t=-2.78; P=0.008) and lower scores on self-directedness (t=3.12; P=0.003). Coping strategies were more passive (t=-2.43; P=0.02), avoiding (t=-2.15; P=0.04) and less well aimed (t=2.64; P=0.01). Surprisingly, the nature of disease (malignant versus non-malignant) did not influence these results, nor was there a difference between males and females, age, years of education, having a relationship or not, or the duration of hospitalization. Thus, contrary to what may be expected in isolation with radionuclide therapy, subgroups such as women, elderly, cancer patients or lower educated people do not, a priori, exhibit a higher state anxiety level. Our study shows these levels to be closely related to individual personality traits and coping strategies that are inadequate for the situation. Screening for trait anxiety before admission can be easily done and may guide interventions aimed at increasing patient comfort and acceptability.

Adaptation, Psychological↗
PubMed1987

[Structural interrelations of the air-blood barrier and terminal sections of the lymphatic link in the pulmonary microcirculatory bed in chronic hypervolemia].

The interalveolar septa of the human lungs are known to have no lymphatic capillaries. The topography of the pulmonary lymphatic system origin under conditions of chronic hypervolemia is still not investigated. Lungs of 24 corpses of persons, died from non-pulmonary pathology (control) and lungs of 34 corpses of persons, died from congenital and acquired heart disease accompanied with pre- and postcapillary forms of the pulmonary circulation hypertension, have been investigated. Decreased efficiency of the microcirculation, increased permeability of the blood capillary walls against the background of hypoxia result in an elevated production of lymph. Intensified collagen formation in the blood vessel walls and in the interalveolar septa is the prerequisite for reorganization of the pulmonary lymphatic bed. Lymphatic capillaries are found to grow into some sclerotic interalveolar septa and into deep structures of the blood capillary walls. This demonstrates a high plasticity of the lymphatic link terminal parts of the microcirculatory bed in pathologically changed lungs.

Blood Volume↗
PubMed1986

The pathology of cot death.

Based on personal investigation of more than 2000 unexpected infant deaths it appears that 'cot deaths' do not form a pathological entity. This concept is supported by detailed pathological studies undertaken in a multicentre study of postperinatal mortality in the United Kingdom. Comprehensive necropsies were performed by paediatric pathologists on 519 infants including 293 whose death certificates indicated cot death. These 519 infants were examined for abnormalities of growth and development, metabolism and immunological status. Together with any evidence of atopy, and of old or recent tissue damage, a summation of disease present was obtained. Examined in this way the author believes that an explanation can be given for almost as many unexpected deaths as for deaths that occur in hospital, that is, are expected.

Humans↗
PubMed1991

Affect in early memories of borderline patients.

Psychoanalytically oriented observers using the framework of object relations theory noted that patients with borderline personality organization manifest serious pathology in their capacity to use internalized imagery to cope with the vicissitudes of separation-individuation. This study examined one source of such imagery, the affect associated with a specific sample of early memories, including the earliest recollections of parents. Patients with borderline personality disorder were compared with paranoid schizophrenics and patients with neurotic character pathology. Forty-five outpatients, 15 in each group, participated in the study. It was found that borderline patients had significantly fewer positively toned early memories than neurotics or paranoid schizophrenics. Only the neurotic group, had a majority of affectively positive memories. The results are generally consistent with object relations theories of borderline psychopathology.

Journal Article↗
PubMed1999

[German-Latvian cooperation in the pathology specialty].

In the field of pathology there have been very close connections since the beginning of this century and a regular exchange of ideas between the pathologists of Latvia and Germany. Pathologists of Latvia were members of the German Association of Pathology. The stages of political changes in Europe very much influenced the exchanges of ideas. The following presentation will outline the activities and personalities in the sector of pathology in the time period until 1918--time of the Russian Czar Empire--, during the National State of Latvia and the Second World War (1918-1940), then during the Russian occupation of Latvia (1944-1991) and also the new time period after the political changes. Evaluated in this presentation the yearly support of the Baltic/German Symposiums, assisted by the IAP, which in addition to the activities in pathology also promote and encourage many personal contacts and friendships.

Germany↗
PubMed1991

PTSD and the Vietnam veteran: the battle for treatment.

1. Patients with post-traumatic stress disorder (PTSD) often encounter treatment that is complicated by professional bias, personal issues, countertransference, and pathological staff dynamics. 2. Treatment is further complicated by diagnostic confusion, the dual diagnoses of substance abuse or depression, and symptoms that mimic personality disorders or psychosis. 3. The special circumstances of the Vietnam conflict that contributed to the susceptibility and etiology of PTSD are the individual characteristics of those who served, the special nature of the war itself and the military strategies used, and the psychosocial and cultural milieu in which it occurred.

Attitude of Health Personnel↗
PubMed1990

[Mental disturbances in the victims of the earthquake in Armenia (based on examination data in the medical institutions of Moscow)].

As a result of examining 211 persons with severe somatic pathology (the crush syndrome, multiple fractures, spinal cord injuries, and so forth) received during the earthquake, 179 (84.8%) manifested psychopathological disorders. Of these, 70 persons (33.2%) had asthenia, consciousness disturbances, insomnia which were viewed as somatogenic, 17 persons (8.1%) with craniocerebral injury had the signs of the establishment of the psycho-organic syndrome, and in 109 persons (51%), the clinical picture was determined by psychogenically conditioned depressive, anxious-phobic and psychopathic reactions. The data obtained allow one to judge the characteristics of the mental status during the subacute period (from the first to the second week) after the earthquake.

Adolescent↗
PubMed2007

Technology insight: will systems pathology replace the pathologist?

By using systems pathology, it might be possible to provide a predictive, personalized therapeutic recommendation for patients with prostate cancer. Systems pathology integrates quantitative data and information from many sources to generate a reliable prediction of the expected natural course of the disease and response to different therapeutic options. In other words, through the integration of relatively large data sets and the use of knowledge engineering, systems pathology aims at predicting the future behavior of tumors and their interaction with the host. In this Review, we introduce the methods used in systems pathology and summarize a recent study providing the first evidence of a concept for this strategy. The results show that systems pathology can provide a personalized prediction of the risk of recurrence after prostatectomy for cancer.

Humans↗
PubMed1983

[The cerebral lesions in congenital toxoplasmosis. Study of 9 personal cases and 61 cases in the literature].

This study is a review of 70 cases of congenital toxoplasmosis; all of the patients were dead between birth and the age of nine. The anatomo-pathological examination of 9 personal cases (6 acute, 1 subacute, 2 chronic) is presented and compared with that of 61 cases from the literature. After a parasitological survey concerning the infectious agent, the author summarizes the macroscopic and the microscopic lesions of his personal cases. Those data are subsequently confronted to those referred to in the literature. The author makes an attempt to entangle the terminological confusion that exists between the different terms: cyst, pseudocyst, microglial nodule and granuloma. The frequency, the localization and the mechanisms of the main alterations - granuloma, necrosis, calcification, hydrocephaly - are studied as well as the vulnerability factors and the resistance of the subjects. The presence in 8 of the 9 chronic cases of calcified scar lesions in the inferior portion of the external wall of the lateral ventricles suggests a particular vulnerability of the spongioblasts in that area. In the acute cases the extensive necroses in the cerebral hemispheres seem to result from immunological reactions in an immature organism rather than from vascular thromboses that appear to be more a secondary phenomenon.

Acute Disease↗