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At least 145 records · Page 8Linked to original sources
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↗
PubMed2003

Endocrine surgical pathology: lesson from pituitary cases that are discordant between clinical and pathologic diagnoses.

There are a variety of clinicopathologic situations of pituitary lesions that could cause a discordance of diagnosis between clinicians and pathologists. This may be caused by confusion of terminology such as "nonfunctioning adenoma" and "null cell adenoma." "Clinically nonfunctioning pituitary adenomas" comprise several pathologically different types of tumors that belong to one of three major cell lineages of adenohypophysial cell types. "Null cell adenoma" was originally defined by ultrastructural features but recently refers to immunonegative adenomas. Unique and unusual types of adenomas such as adenomas with "honeycomb Golgi" appearance and silent subtype 3 adenomas may cause a discordance of diagnosis. Because of mild elevation of prolactin levels, these adenomas are sometimes erroneously diagnosed as prolactinoma. Careful pathologic study with immunohistochemistry and electron microscopic examination, as well as communication between clinicians and pathologists, is vital. Confusion of terminology should be discussed. Awareness of rare disease entities is also required. Thorough analysis of individual cases with diagnostic inconsistency may provide a useful lesson for better understanding of endocrine diseases and for appropriate treatments.

Adenoma↗
PubMedDate not supplied

[From Virchow's cellular pathology to modern molecular pathology].

Evolution of Virchow's cellular pathology into molecular biology and molecular pathology due to achievements of cytology, biochemistry (histochemistry), immunology (immunomorphology) and genetics as well as new opportunities opened by integration of these disciplines (electron histochemistry, immunohistochemistry, immunogenetics, etc.).

History, 19th Century↗
PubMed1988

Teaching pathology in the 21st century. An experimental automated curriculum delivery system for basic pathology.

In late 1984, the "General Professional Education of the Physician" (GPEP) report recommended, among other things, that medical curricula be revised to rely less on lectures and more on independent study and problem solving. We seem to have anticipated, in 1980, the findings of the GPEP panel by formulating and starting to test the hypothesis that certain "core" information in medical curricula can be as effectively delivered by technology-based self-study means as by lecture or formal laboratory. We began, at that time, to prepare a series of self-study materials using, at first, videotape and then computer-controlled optical videodiscs. The content area selected for study was basic microscopic pathology. The series was planned to cover the following areas of study: cellular alterations and adaptations, cell injury, acute inflammation, chronic inflammation and wound healing, cellular accumulations, circulatory disturbances, necrosis, and neoplasia. All are intended to provide learning experiences in basic pathology. The first two programs were released for testing in 1983 as a two-sided videodisc accompanied by computer-driven pretests, study modules, and posttests that used Apple computers and Pioneer (DiscoVision) videodisc players. An MS DOS (eg, IBM) version of the computer programs was released in 1984. The first two programs are now used in 57 US, Canadian, European, and Philippine health professions schools, and over 1300 student and faculty evaluations have been received. Student and faculty evaluations of these first two programs were very positive, and, as a result, the others are in production and will be completed in 1988. Only when a critical mass of curriculum is available can we really test our stated hypothesis. In the meantime, it is worthwhile to report the evaluation of the first two programs.

Audiovisual Aids↗
PubMed1987

Statistical techniques reported in pathology journals during 1983-1985. Implications for pathology educators.

The increasingly scientific basis of medicine challenges pathology educators to incorporate quantitative skills into a very compressed curriculum. One strategy is to focus training on the statistical techniques pathologists will most commonly encounter in their literature. We identified the reporting of statistical techniques in nearly 5200 original articles published during 1983-1985 in 16 journals important to pathology. Our results suggest that a reader familiar with 12 fundamental statistical concepts can evaluate knowledgeably over 95% of the quantitative findings reported in these journals. With the exception of survival analysis and pharmacologic modeling, these techniques are typically encountered in many introductory statistical texts. In numerous articles, failure to identify the statistical methodology used made it impossible to identify the analytic procedures used and, hence, judge the scientific validity of results.

Curriculum↗
PubMed1979

Forensic pathology--the hidden specialty: A survey of forensic pathology training available to medical students and residents.

It is no wonder that some people refer to forensic pathology as the "hidden specialty." This paper shows evidence that the only exposure given to most medical students is a brief, all-too-explicit demonstration ("horror show") of interesting cases that can only attract the bizarre of mind into the field. It is further pointed out that even residents in pathology receive scanty, if any, formal training in most medical school residency programs, in spite of the fact that two thirds of the medical schools responding have one or more forensic pathologists on their faculty. The obvious answer is a change in the curriculum if this increasingly important subspecialty is to be saved.

Curriculum↗
PubMed1983

[Role of neuropathology in general pathology and special pathologic anatomy].

The development of neuropathology into a special working field began in the second half of the 19th century in accordance with the clinical requirements arising from an increasingly scientific approach to mental and nervous diseases. The progress made also in this discipline is based on improved methods and the nervous system can only be understood from its interactions with other organs and the environment. The subject of the study and special relations to clinical and theoretical branches as well as morphological working and thinking are the basis of a subspecialisation of Neuropathology with an integration into General Pathology and Special Pathological Anatomy, in order to avoid an isolation.

Europe↗
PubMed1983

The clinical-pathologic forum in oral pathology.

A clinical-pathologic "forum" has been employed for the past three years as the laboratory component of the predoctoral course in oral pathology at the University of Connecticut School of Dental Medicine. In addition to instruction in oral histopathology, this format provides an effective matrix for the development of descriptive skills and diagnostic discipline in clinical problem solving. The method is described and discussed.

Education, Dental↗
PubMed1982

[Important results of experimental-theoretical pathology and etiopathogenetical research of the Institute of Pathology of Leipzig].

Since the appointment of L. Wagner to the first full professor of pathology at the University of Leipzig there are past 112 years. Based on the analysis of the scientific works during this period the author tries to characterize the whole profile of the institute among the different directors and to show the important results of the experimental-theoretical pathology and of the etiopathogenetical research. These results are concentrated upon 3 themes: inflammation, atherosclerosis and diabetes mellitus. The investigations about the inflammation by Cohnheim and Marchand and those about the allergic inflammation by Klinge are of special importance. Beside these well-known men numerous co-workers have contributed with experimental and morphological work to the scientific profile of the institute.

Arteriosclerosis↗
PubMed1993

Pathologic findings from the National Surgical Adjuvant Breast Project protocol B-06. 10-year pathologic and clinical prognostic discriminants.

BACKGROUND: Prognostic pathologic and clinical features for 10-year survival were determined from 22 pathologic and 5 clinical variables encountered in 1090 node-negative and 651 node-positive patients enrolled in NSABP protocol B-06. METHODS: All factors were first screened univariately. Those exhibiting P values < 0.01 were entered into multivariate Cox regression models. The model with the best fit consisted of 951 negative-node and 496 node-positive patients. RESULTS: Better survival in node-negative patients was noted for whites rather than blacks, for patients with favorable tumor types (tubular, mucinous, papillary) rather than intermediate (lobular invasive, classical medullary, and not otherwise specified [NOS] combinations) or unfavorable forms (NOS pure and atypical medullary), and for tumors with good rather than poor nuclear grade. Number of nodal metastases, degree of tumor elastosis, and patient age younger than 40 years of age and 65 years of age and older in addition to nuclear grade and race were found significant for node-positive patients. Relative risks for combinations of these prognostic factors were multiplicative. CONCLUSIONS: The prognostic factors for node-negative patients were similar to those observed for this cohort at 8 years. Some differences noted between patients of both nodal groups in NSABP B-04 and B-06 may be related to selection requirements in the latter and hence different patient characteristics or more speculatively a change in tumor biology.

Adult↗
PubMed1995

Inflammatory carcinomas of the breast: a clinical, pathological, or a clinical and pathological definition?

Some controversy remains about the clinical or pathological definition of the different types of inflammatory breast cancer (IBC) and especially the diagnostic and prognostic value of dermal lymphatic involvement. Our purpose was to classify the different types of IBC for which diagnosis was confirmed intraoperatively and ascertain features allowing reliable diagnosis. We studied clinical findings, biological data, and treatment outcome in a series of 144 successive patients. Our results suggest that there are 2 biologically different entities i.e., true IBC and pseudo-IBC. True IBC, whose course is currently fatal in all cases, can be divided into 2 sub-categories i.e., common true IBC (75.7% of cases), in which inflammatory signs occur primarily or secondarily, and occult true IBC (13.2% of cases). Dermal emboli have been observed in 61% of common true IBC, but their absence did not alter the rapidly unfavourable outcome. Extensive lymph-node involvement, other biological features and survival were the same in the 2 sub-categories. Pseudo-IBC (11.1% of cases) can easily be confused with common true IBC. The biological characteristics of pseudo-IBC differ from those of true IBC: no dermal lymphatic involvement and little or no lymph-node involvement. Despite large tumour size, outcome was particularly favourable. It is of great importance to differentiate true and pseudo-IBC, for which the treatments are different. Confirmation of true IBC requires pathological demonstration of dermal lymphatic emboli or extensive lymph-node involvement. Occult IBC must be identified for patients presenting rapidly growing tumours.

Adenocarcinoma↗
PubMed2000

Case studies in pathology from the National Museum of Health and Medicine, Armed Forces Institute of Pathology.

The National Museum of Health and Medicine was founded as the Army Medical Museum during the American Civil War to document the effects of war wounds and disease on the human body. Since then, the Museum has created a collection of documented pathologic specimens that can be used to study the gross and microscopic appearance of disease conditions. The Museum's collections are a vital link to the past and the future of medical research and form a unique national medical repository that is used continuously for research, education, and exhibit purposes. Today, the Museum in association with its parent institution, the Armed Forces Institute of Pathology, provides access to over 130 years of documented medical specimens. These specimens allow the unique opportunity to re-examine historical classification systems and disease diagnoses. The case of subacute chronic osteomyelitis with cortical sequestration of Private J. Potter from the Civil War is presented here.

Amputation, Surgical↗
PubMed2004

Biomechanical analysis of pedalling for rehabilitation purposes: experimental results on two pathological subjects and comparison with non-pathological findings.

In this paper the experimental results obtained by means of a prototype measuring device dedicated to the evaluation of the rehabilitation level of the lower limb are presented. The analysis of the experimental data collected on non-pathological subjects allows the identification of the characteristic meaning of the most significant parameters typical of healthy subjects. These data have been employed for a systematic comparison with the same parameters measured on two pathological subjects, in order to define quantitative indicators of the rehabilitation degree of the lower limbs and indicators of the "quality" of the movement.

Adult↗
PubMed2003

CMV infection of the renal allograft is much more common than the pathology indicates: a retrospective analysis of qualitative and quantitative buffy coat CMV-PCR, renal biopsy pathology and tissue CMV-PCR.

BACKGROUND: Quantitative blood polymerase chain reaction (PCR) for cytomegalovirus (CMV) is used to direct therapy in kidney transplant patients, but cytomegalic inclusions are rarely found in allograft renal biopsies even with an elevated serum creatinine and apparent CMV disease. The relationship between quantitative blood CMV and renal allograft pathology is unknown. METHODS: Thirteen biopsy samples were available for analysis from patients suspected of CMV disease, who had a buffy coat CMV-PCR drawn within 2-5 days of a renal allograft biopsy for an elevated creatinine. All were evaluated for CMV pathologically, by light microscopy, immunohistochemistry, in situ hybridization and tissue PCR. RESULTS: Qualitative and quantitative buffy coat CMV-PCR were positive in 10/13 (77%) patients. Tissue CMV-PCR was positive in five (50%) biopsies, including two with CMV inclusions and three with no inclusions. Quantitative buffy coat CMV-PCR levels did not correlate with detection of CMV inclusions in renal tissue. Paradoxically, quantitative buffy coat CMV-PCR was low (239 and 538 copies/microg of DNA) when CMV inclusions were detected. All five biopsies with acute rejection were associated with CMV viraemia and two of the five with allograft CMV inclusions. A quantitative buffy coat CMV-PCR of <100 copies/microg of DNA ruled out disease with CMV inclusions. CONCLUSIONS: CMV nephropathy is much more common than previously reported when sensitive techniques are used for detection in tissue. Acute rejection and CMV viraemia occur commonly together in patients at risk for CMV. Quantitative buffy coat CMV-PCR does not correlate with the presence of CMV inclusions. These findings have implications for management of patients who have elevated serum creatinine and are at risk for CMV disease.

Biopsy↗
PubMed2000

Recommendations for handling radioactive specimens obtained by sentinel lymphadenectomy. Surgical Pathology Committee of the College of American Pathologists, and the Association of Directors of Anatomic and Surgical Pathology.

Sentinel lymph node biopsy has been shown to be an accurate predictor of axillary nodal status in invasive breast cancer and is a useful alternative to axillary dissection for some patients. Because radioactive materials are often used to identify the sentinel lymph node, concerns have been raised regarding the safe handling of tissue specimens obtained by this technique. The Surgical Pathology Committee of the College of American Pathologists and the Association of Directors of Anatomic and Surgical Pathology have developed recommendations for the safe handling of radioactive specimens obtained by sentinel lymphadenectomy.

Axilla↗
PubMed1976

Changing concepts in the management of pathological and impending pathological fractures.

The benefits in the management of pathological fractures by internal fixation are well recognized. However, failures in bone or metal can occur where there is a large amount of bone destruction. Seven of 69 pathological fractures in our series were treated by internal fixation with adjunctive use of methylmethacrylate without failure. This allowed for secure fixation in fractures with large amounts of bone destruction, thus decreasing the patient's pain and allowing earlier mobilization. Neither the effects of radiotherapy on bone involved with neoplasm nor methylmethacrylate are altered when radiotherapy is used after internal fixation and adjunctive use of methylmethacrylate. We believe that an aggressive program of stabilization of these fractures or fixation before actual fracture provides significant patient benefits including reduction of pain, decreased length of hospital stay, reduction of financial expense, and return to as near normal function as possible.

Adolescent↗
PubMed1980

The surgical treatment of pathologic and impending pathologic fractures of the long bones.

The results of operative treatment of 83 pathologic fractures and 17 impending pathologic fractures of the long bones are reported. The results of a group of 53 patients who underwent an osteosynthesis only are compared with those of a group of 43 patients who were subsequently treated 47 times with an osteosynthesis in combination with bone cement. With regard to the degree of mobilization there is a statistically significant difference in favor of the group treated with bone cement. The incidence of complications is low. Immediate use of the involved extremity in these patients minimizes complications associated with prolonged immobilization and enhances the quality of the remainder of their lives.

Adult↗