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PubMed2004

[Angelo Maria Maffucci (1845-1903) and the beginning of pathological anatomy in Pisa].

In 1884, at the Faculty of Medicine of the University of Pisa, the new chair of pathology was inaugurated and Angelo Maria Maffucci was appointed first director. Angelo Maffucci was born in 1845 in Calitri, near Avellino, from a farming family. After graduating in medicine at Naples, in 1872, he started his scientific work at the institute of pathology, under Otto von Schrön (1837-1917). He was professor of general pathology in Messina then Professor of pathology at the university of Catania. In 1884 assumed the role of chairman of pathology at the university of Pisa, where he died in 1903. His scientific contribution is recorded in the massive collection of his personal notes, sketchbooks and watercolours. In 1881 he described, for the first time, the disease characterized by an enchondroma with multiple angiomas, known as Maffucci's Syndrome. The most important scientific contribution was in the field of tuberculosis. Maffucci asserted that avian tuberculosis had a different aetiology from the bovine and human forms. This revolutionary theory caused a strong scientific conflict with Robert Kock. In the last years of his life his pioneering research provided the basis for the following modern investigations to produce vaccines from living bacilli. As a person he was described as brilliant and modest, shy and rigorous.

Animals↗

PubMed2005

[Study on integrative point of traditional and western medicine--from "integrative disease and syndrome" to "integrative pathological process and syndrome"].

The clinical thinking modes of "integrative disease and Syndrome" and "integrative macroscopical Syndrome-differentiation and microscopical Syndrome-differentiation" formed in the past half century were merely the primary train of thought and methodology of integrative traditional Chinese and Western medicine. In order to develop them to a higher level, stress should be put on the unity and holism of disordered organism and unity of function, structure and metabolism. It has long been ignored that a parallel and correlated relationship exists between the TCM Syndrome and pathological process of Western medicine, which is a common, set-formed and regular pathophysiological changes with certain development phase, presented in various diseases. Both have common features as that the same pathological process can be seen in different diseases and several pathological progresses can present in one disease, the same Syndrome also can be seen in different diseases and several Syndromes can present in a disease. Moreover, they have the compatible connotation and denotation. The author deduced that pathophysiological basis of main Syndrome is indeed the basic pathological process. Essence of Syndrome is the related pathological processes including abnormal changes in function, metabolism and morphological structure.

Biomedical Research↗

PubMed2005

Automating tissue bank annotation from pathology reports - comparison to a gold standard expert annotation set.

Surgical pathology specimens are an important resource for medical research, particularly for cancer research. Although research studies would benefit from information derived from the surgical pathology reports, access to this information is limited by use of unstructured free-text in the reports. We have previously described a pipeline-based system for automated annotation of surgical pathology reports with UMLS concepts, which has been used to code over 450,000 surgical pathology reports at our institution. In addition to coding UMLS terms, it annotates values of several key variables, such as TNM stage and cancer grade. The object of this study was to evaluate the potential and limitations of automated extraction of these variables, by measuring the performance of the system against a true gold standard - manually encoded data entered by expert tissue annotators. We categorized and analyzed errors to determine the potential and limitations of information extraction from pathology reports for the purpose of automated biospecimen annotation.

Abstracting and Indexing↗

PubMed2006

Integrating anatomical pathology to the healthcare enterprise.

For medical decisions, healthcare professionals need that all required information is both correct and easily available. We address the issue of integrating anatomical pathology department to the healthcare enterprise. The pathology workflow from order to report, including specimen process and image acquisition was modeled. Corresponding integration profiles were addressed by expansion of the IHE (Integrating the Healthcare Enterprise) initiative. Implementation using respectively DICOM Structured Report (SR) and DICOM Slide-Coordinate Microscopy (SM) was tested. The two main integration profiles--pathology general workflow and pathology image workflow--rely on 13 transactions based on HL7 or DICOM standard. We propose a model of the case in anatomical pathology and of other information entities (orders, image folders and reports) and real-world objects (specimen, tissue samples, slides, etc). Cases representation in XML schemas, based on DICOM specification, allows producing DICOM image files and reports to be stored into a PACS (Picture Archiving and Communication System.

Diagnostic Imaging↗

PubMed2006

[On "early pathologic anatomy" and "anatomy of medical structure": continuity or point of epistemological rupture?].

The aim of this paper is to analyse the technical, conceptual and institutional changes from which, through macroscopic pathology, a new medical science (microscopic pathology) emerged. The "early" pathology was mainly implemented by the Ecole de Paris, at the beginning of the 19th century. After 1850, histo-pathology emerged, in German university institutes (which were separate buildings from the wards and from the dissecting rooms of the hospitals). The birth of histo-pathology is also linked with technical improvements in mass manufactured microscopes, with better techniques for fixing and staining histological samples and lastly, in (1848) withVirchow's cellular theory. Among French doctors, only one, the very famous physician Jean-Martin Charcot (1825-1893) was aware of these dramatic changes. Charcot wrote many texts which are testimonies of an epistemological rupture between two very different types of medicine, the old French "médecine d'hôpital" and the new "lab medicine", developed in German speaking countries and based on the microscope.

France↗

PubMed1991

[Analysis of 1410 examinations of fetal pathology at the University Hospitals of Bordeaux].

We present a retrospective study of 1,410 fetal pathological examinations performed in the department of pathology of the CHU de Bordeaux. Initially, the recruitment of the cases was limited to the three maternity units of the CHU. Public and private maternities and departments of pediatrics from the whole of Aquitaine (S.W. province) as well as a certain number of neighbouring provinces now send us their material for analysis. Fetal pathological examination is systematically indicated in cases concerning spontaneous abortion, pregnancies terminated after prenatal diagnosis and stillbirths. Autopsies performed on children aged from 0 to 1 year have been included. The same technique has been used for all examinations and the data have been recorded on a computerized system (Centre Régional d'Informatique Hospitalière). Current data analysis for age at death, sex-ratio, maternal age, mode of abortion and pathological conditions are given. We found at least one pathological anomaly in 43.2% of the spontaneously aborted fetuses and stillbirths. Nevertheless, our aim is to demonstrate that foetopathology units can play a role not only for diagnoses having a significant impact on genetic counseling, but also as a database for epidemiological studies.

Autopsy↗

PubMed1991

[The future of pathology in Czechoslovakia].

Further development of Czechoslovak pathology depends on the worldwide speed and direction of progress in pathology, on economical and political progress, and on transformation of the Czechoslovak health care system. Changing orientation of pathology in advanced countries predicts an increased importance of working qualities in the whole scope of pathologist. Intrinsic factors controlling progress in pathology are varied and can be partly influenced. Participation of pathology in the new system is to be actively prepared by mutual information and cooperation.

Czechoslovakia↗

PubMed1991

[Comparative pathology; territory with many streams].

Normal and abnormal situations in the reptilian ovary are reviewed. The normal development of the ovary is mainly governed by the temperature and variations in length of daylight. Vitellogenesis, (the production of yolk) takes place in the liver and is regulated by oestrogens. Under an abnormal light regimen, for instance 12 hours of light--12 hours of darkness, erratic vitellogenesis may occur. Atresia or resorption of follicles may occur at all stages of their development. The pathology of the process of resorption is characterised by the invasion of blood vessels and phagocytosis of yolk by macrophages. Pseudopregnancy is referred to for the first time. An important pathological aspect is the sterile inflammation of the ovary, which is fairly common in reptiles. The pathogenesis most probably is a trauma or some other defect of the egg membrane, resulting in leakage of vitelline into the surrounding fatty tissues. This contact gives rise to a chronic granulomatous inflammation. Comparative pathology covers a very wide field. In the Department of Special Animal Pathology, the specialization known in other areas of the veterinary profession, is directed towards a concentration of staff members on certain groups of animals such as mammals, birds, reptiles and laboratory animals respectively. At thesis was advanced, stating that a problem-solving attitude of the students cannot be solely attained by participation of veterinary students in fundamental research. The department of veterinary pathology is devoted to a problem-solving mode of education of students.

Animals↗

PubMed1988

Integrated pathology reporting, indexing, and retrieval system using natural language diagnoses.

Pathology computer systems are making increasing use of natural language diagnoses. The Johns Hopkins Medical Institutions integrated pathology reporting system, a commercial product with extensive, locally added enhancements, covers all information management functions within autopsy and surgical pathology divisions and has on-line linkages to clinical laboratory reports and the medical library's Mini-MEDLINE system. All diagnoses are written in natural language, using a word processor and spelling checker. A security system with personal passwords and different levels of access for different staff members allows reports to be signed out with an electronic signature. The system produces financial reports, overdue case reports, and Boolean searches of the database. Our experience with 128,790 consecutively entered pathology reports suggests that the greater precision of natural language diagnoses makes them the most suitable vehicle for follow-up, retrieval, and systems development functions in pathology.

Artificial Intelligence↗

PubMed1988

[Present-day pathological anatomy and prospects for its development in the 21st century].

Scientific Societies of Pathologists from Socialist countries held three symposia to analyse recent developments and future trends in pathology. The author presents his state-of-the-art review at the third symposium (Berlin, 1987) based on international literature data and first-hand experience gained in the field of pathology for the last decades. Some negative tendencies are considered. It is stated, in particular, that the percentage of autopsies performed in those who died at hospitals and at home continues to decrease due to fading interest to autopsy results both from physicians and medical authorities. This can entail growing number of misdiagnoses, unassessed quality of medical aid in complicated cases, biased statistics, undetected infection during life, defects in medical training. Tendencies and tasks facing histopathology and cytological diagnosis are determined as follows: 1) purpose-specific introduction of new techniques and equipment 2) active promotion of interdisciplinary task-force groups of clinicians, pathologists, roentgenologists, etc. to verify diagnosis and develop new techniques 3) establishment of special reference centres 4) overall computerization 5) urgent need in additional skilled staff to satisfy growing technical requirements of molecular biology, genetics and tissue culture. Current research on pathology is believed unsatisfactory. The role of experimental pathology is underestimated. To improve the situation in fundamental pathological research, the author suggests large-scale perestroika involving additional investments and human resources, active participation of scientists, clinical pathologists and medical authorities.

Europe, Eastern↗

PubMed1985

Manpower needs and supply in academic pathology.

A survey of manpower supply and need in academic pathology departments was conducted by the Joint Task Force on Pathology Manpower of the College of American Pathologists, the American Society of Clinical Pathologists, and the Association of Pathology Chairmen by means of questionnaires distributed to chairmen and faculty of all departments of pathology and laboratory medicine in the United States. Of the 136 departments, responses were obtained from 131 (96%) chairmen and from 1,561 (45%) faculty members. The current total need for faculty members (funded vacant positions) is 272, and the projected aggregate need over the next five years is 693 members for new and replacement positions. The greatest needs are for research MD pathologists and surgical pathologists, followed by autopsy and chemical pathologists. Based on the estimate of current pathology trainees planning academic careers, there is a strong indication that the projected supply of MD pathologists is significantly less than the anticipated demand.

Academic Medical Centers↗

PubMed1983

[Pathologic anatomy of childhood diseases today].

The main problems developed by M. A. Skvortsov, the founder of pathology of childhood diseases in the USSR, are dealt with. M. A. Skvortsov worked on pathology mainly of infectious diseases analysing them from the point of view of the patterns of responsiveness of the child. New information which has at present enriched the theory of child's responsiveness is given: enzymatic systems and their defects, endocrine regulation and the importance of the enterine system, immune responsiveness and the importance of its defects. The current status of pathology of modern infectious diseases of childhood, in particular, umbilical sepsis, oncological diseases, etc. are dealt with. The role of organization of the childhood pathological service for further development of the M. A. Skvortsov's theory concerning pathology of childhood diseases is indicated.

History, 19th Century↗

PubMedDate not supplied

Diagnostic ultrastructural pathology--sub-speciality or special stain?

The high resolving power of the electron microscopy gives ultrastructural pathology many of the features of a 'sensitive, multipurpose stain'. But the high resolution gives rise to problems of evaluation since most pathological features of disease are specific in a quantitative rather than in a qualitative way. Thus, pathological changes may be of diagnostic importance when they are severe enough to be seen by light microscopy, but less so when only revealed by electron microscopy. Problems of evaluation and interpretation should not lead to paralysing nihilism but should make us realize that electron microscopy does not represent the ignorant pathologist's key to a diagnostic heaven, no more than do special stains, histochemistry and immunocytochemistry. At present it may be necessary to organize ultrastructural pathology as a kind of sub-speciality of pathology. In the long run, we feel that sub-specialities should be related to the object studied rather than to the instrument used. Thus, the neuropathologist should do ultrastructural neuropathology, the cytologist ultrastructural cytopathology, etc. in the same way as most kidney pathologists already do their own ultrastructural work.

Diagnosis, Differential↗

PubMed1994

[Basic trends in general human pathology and principles of its teaching in higher medical education].

The paper considers the current trends in the development of biological and medical sciences: their subject, tasks, methods, and place of General Human Pathology among other subjects, its value for the clinical discipline. It defines and analyzes the most topical and disputable directions of General Human Pathology, primarily including those which form the bases for the pathology theory. Arguments are advanced for the necessity of introducing the subject General Pathology of Man into the curriculum of higher medical educational establishments at various faculties. Consideration is given to the specific features of this subject teaching at the faculty training researchers and research pedagogical personnel, at the Pharmaceutical and Higher Nurse Training Faculties of the I. M. Sechenov Moscow Medical Academy. A proposal is given to consider and to discuss the most important problems of General Pathology and its teaching, which are listed in the paper.

Education, Medical↗

PubMed1995

[Pathological findings of proximal tubal occlusive infertility].

Exicised tubal segments (including interstial and isthmic portions) from 33 women with proximal tubal occlusive infertility were examined pathologically. We found that pathologic entities included chronic tubal inflammation (70.59%), tubal endometriosis (9.80%), obliterative fibrosis (7.84%), salpingitis isthmica nodosa (5.88%), tubal tuberculosis (3.92%). Only one of the tubes (1.96%) showed no obvious pathological change. These observations on proximal tubal occlusion in combination with clinical features and pelvic changes indicate that: (1) These are multiple distinct pathologic patterns, and pelvic findings do not predict the pathologic changes of the tubes. (2) Induced abortion and uterine curetage is an important factor for the proximal tubal occlusive infertility. Pelvic inflammatory disease and intrauterine device are other factors.

Abortion, Induced↗

PubMed1994

Technology assessment in anatomic pathology. An illustration of test evaluation using fine-needle aspiration biopsy.

Although anatomic pathology diagnoses are the standard on which treatments often are based, many facets of anatomic pathology have not been rigorously examined. These areas include the evaluation of a procedure's technical and diagnostic characteristics, clinical utility, and cost. Technology assessment is the disciplined scientific and systematic evaluation of a test or procedure, and it can be used to evaluate these areas in anatomic pathology. To illustrate and promote the use of technology assessment in anatomic pathology, we show examples in fine-needle aspiration biopsy, which is a subspecialty of cytopathology. We discuss some of the more commonly encountered problems and misconceptions of test evaluation and also the need for further fine-needle aspiration biopsy evaluation. We conclude that technology assessment is a powerful but underutilized tool for test evaluation in fine-needle aspiration biopsy and in anatomic pathology.

Biopsy, Needle↗

PubMed1994

[Development of a computer-assisted system to teach pathologic anatomy. Preliminary results].

BACKGROUND: The present study describes the implantation of an interactive teaching system to improve both the active involvement of the student and the learning quality of Pathology. The preliminary results from the evaluation of such system are also reported. METHODS: Two attitude questionnaires (rating scale) were passed to a sample of 36 students of Medicine, randomly elected. These students used for 10 weeks a programme of Pathology (Interpat) assisted by computer. Moreover, the data stored after each session by the control stack of this programme are analyzed. RESULTS: The programme is positively evaluated by the users who consider it as an appropriate mode of learning Pathology. In spite of the scarce experience with computers, students have no difficulty in using this programme. 82% of students consider that they learn more Pathology with Interpat than with the traditional system of magistral classes. 63% of students believe that similar systems must be applied in other curricula. The average time of use of the system by each student has been 11 h 45 min (SD 4 h 55 min). The videodisc is the stack more used. CONCLUSIONS: There is a good acceptance of this methodology by the students, being almost no difficulty in using the programme, despite their low level of computer knowledge. The program is a potent instrument for individualizing the teaching of Pathology. The small size of the sample, accurate for a preliminary study as this is, must be take into account when generalizing the results.

Computer-Assisted Instruction↗

PubMed1995

["Quick Return Service" of the surgical pathology].

The "Quick Return Service" of laboratory information would be the service for patients and clinicians that supply the laboratory information the instance that the specimens and the requests of laboratory examinations are accepted by the laboratory on the basis of the hospital information system (HIS) and the high-speed hospital transportation system of the specimens. Is the "Quick Return Service" of the pathological diagnosis possible and necessary? This question led the author to review the technical environments of the pathological diagnosis, especially of the frozen section diagnosis through our experience at the surgical pathology division of the Department of Laboratory Medicine of National Defense Medical College (NDMC) Hospital. Through the review, it appears that the supporting system for surgical pathologists to frozen section diagnosis ("Quick Return Service") is essential. Pathologists often need clinical and radiological information at the pathological diagnosis. For quick gaining of the information by surgical pathologists on the "Quick Return Service", the efficient HIS including hospital PACS (picture archiving and communication system) is necessary. Standardization and quality assurance of images of frozen section are also necessary. The technical environments of telepathology are developing. The interinstitution consultation through the telepathology will be the indispensable help for the "general" surgical pathologists confronting the problematic cases in the small hospitals that are deficient of pathologists. With the help of staff of the surgical pathology division of the NDMC hospital and the technologists of Mitsubishi Electronics, Co, the author has tried to develop the archiving system of frozen section pictures on the digital image management system.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Laboratory Information Systems↗