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PubMed1990

Classification of gastric carcinoma.

In this review the main classification systems of gastric carcinomas are described. Besides topographical aspects, the macroscopic features of early and advanced gastric cancers are summarized. Also scanning microscopic typings, the WHO typing, and various histogenetic classifications are reviewed. The main prognostic categorizations, like the TNM classification of the UICC and the Japanese classification of lymph nodes, are described, together with their prognostic significance. Finally, the special significance of the R classification is stressed.

Carcinoma↗
PubMed1989

Classification of endometriosis.

The classification of endometriosis has evolved during this century under the influence of many factors. Although classifications initially paralleled the staging of pelvic malignancies, more modern systems follow the natural progression of this pathologic process. The diagnosis of endometriosis at earlier stages has been limited by the technology of the era. Previously, only patients with more severe disease or symptoms were evaluated and treated. Earlier therapies were more radical and centered on pain relief achieved with removal of the internal genitalia. The objectives of classification were to provide standardized documentation of the disease and--it was hoped--define those patients amenable to less radical therapy. As our diagnostic and therapeutic capabilities grew, so did our interest in infertile women with endometriosis and the treatment of such patients. The diagnosis of endometriosis was often made at an earlier stage of involvement, and therapy stressed repair rather than removal. Description of pelvic involvement, has become more detailed and accurate, and the stage of disease has become prognostic of future fertility. The basic tenet of the R-AFS classification system is to provide an objective and universal method for describing the severity of disease visualized at laparotomy or laparoscopy. Stage of disease will aid the physician in choosing the therapy most suited for the individual patient. If reparative surgery is undertaken, the stage of disease will reflect the extent of pelvic reconstruction required. Quantifying disease severity will, it is hoped, make it predictive of success in conception and prognostic of the need for future medical or surgical treatment. It will also serve to stratify patients with a similar degree and distribution of disease into somewhat homogeneous groups. This will permit reasonable comparisons of effectiveness of different therapies and investigators' methods. Refinement of this type of classification scheme will depend on critical analysis of the system's prognostic capabilities. Further studies will help elucidate the relative importance of individual variables on the potential for success in achieving pregnancy.

Endometriosis↗
PubMed1989

Lymphadenopathy in HIV infection: histological classification and staging.

The histological alterations seen in HIV-related lymphadenopathy have been described with different terms by different authors. In order to facilitate comparisons of results from various laboratories, a group of pathologists of the European Lymphoma Study Group (later the European Association for Haematopathology) have proposed a histological classification for the evaluation of HIV related lymphadenopathy. Most observers agree that the morphological and immunohistochemical alterations in the follicles (germinal centres) are the most conspicuous and earliest changes seen. The follicular alterations were therefore used as the basis for the proposed classification. In addition, some features occasionally seen were also included, i.e. angioimmunoblastic hyperplasia, multicentric Castleman-like lesions, and vascular lesions, especially pretumorous and tumorous stages of Kaposi's sarcoma. The proposed classification was used by the members of the group of a collection of lymph nodes compiled from the various centres. The classification was shown to be reproducible and to have clinical relevance in staging of the patients. The prognostic relevance as to the survival of the patients has to be further substantiated by follow-up studies. The proposed classification offers a common terminology for the alterations previously described by different terms by various authors.

AIDS-Related Complex↗
PubMed1989

[Aspects of the 10th decennial revision of the international statistical classification of diseases (ICD-10)].

The author gives a critical account of some general principles of the project of classification ICD-10, changes in the classification of items in the area of endogenous psychoses, neuroses psychogenic conditions and personality disorder respectively. Changes in the mentioned groups may at first cause some embarassment, in advocates of defined schools even indignation. The author evaluates positively the shift of schizoaffective psychoses to affective disorders; omission of neurotic depression is probably premature. Simple schizophrenia could be classified as it was so far. The problem of latent schizophrenia is more complicated. The classification will enrich clinical thinking by progressive elements of operational diagnosis and partly also by multiaxial diagnosis by introduction of the code which records the importance of psychosocial stress ("Z"). It may stimulate the declining interest in phenomenology and nosology. In general the ICD-10 project is considered a necessary and in some instances useful compromise with principles of DSM-III classification. Its introduction will cause transient difficulties. Only after some experience with the new classification and validating studies it will be possible to express a more responsible opinion on the project.

Humans↗
PubMed1977

Rappaport classification of non-Hodgkin's lymphoma: histologic features and clinical significance.

The architectural arrangement of the neoplastic cells and their cytologic identification form the histologic basis of the Rappaport classification of non-Hodgkin's lymphomas clinical studies have shown the favorable prognosis of the nodular lymphomas while the diffuse lymphomas irrespective of cell type have a poor prognosis. Several recent studies have shown that pathologists can identify the nodular and diffuse patterns with a high degree of reproducibility. The cytologic subclassification has, however, not achieved a similar high degree of reproducibility. The Southwest Oncology Group study has shown the most reproducible subgroups to be the nodular poorly differentiated lymphocytic malignant lymphoma (ML) and the diffuse histiocytic ML. The clinical significance of the Rappaport classification when applied to childhood lymphomas is not as clear as in adult lymphomas. In view of the recent description of a new clinicopathologic entity primarily in children and adolescents (ie, lymphoblastic ML), IT IS APPARENT THAT THE CHILDHOOD LYMPHOMAS Will have to be examined more critically in order to determine the clinical significance of this classification. Although some have proposed new classifications of these lymphomas based upon immunologic identification of cell origin, none have been shown to be of clinical significance. Based on recent immunologic and clinical studies, a modified classification of the non-Hodgkin's lymphoma is proposed which does not alter its clinical usefulness.

Burkitt Lymphoma↗
PubMed1977

Pathology of the non-Hodgkin's lymphomas: new classifications.

This paper briefly reviews the various classifications proposed as alternatives to that of Rappaport. Rappaport's classification is valuable because it is applicable to clinicopathologic studies, but there are areas of contention. Following the Airlie Conference, which failed to resolve the current controversy about classification, the National Cancer Institute proposed to support a retrospective study of 1000 cases of non-Hodgkin's lymphoma, during which the various classifications will be applied to the biopsy slides by a selected panel of pathologists. It is hoped that this study will meet the urgent need for a classification which will eliminate controversial terminology and will employ terms acceptable to pathologists in their daily diagnostic work and to hematologists and oncologists burdened with the choice of therapy for patients affected by the non-Hodgkin's lymphomas.

Child↗
PubMed1986

[Does Ming's classification of gastric carcinomas have epidemiologic or prognostic value?].

The population based registry of digestive tract tumours of the country of Cote-d'Or was used to assess the epidemiological and prognostic value of Ming classification. The 211 gastric carcinomas operated or autopsied between 1976 and 1981 in this population were reviewed on a pathological basis. The expansive type (46.0%) was nearly as frequent as the infiltrative type (47.9%). In 6.2% of the cases it was impossible to classify carcinomas in one of these two types. The male/female ratio was higher in the expansive type (3.0) than in the infiltrative type (2.2) and the mean age of patients at the time of diagnosis was higher in the expansive type (69.5 years) than in the infiltrate type (66.4 years p less than 0,05). Ming classification was difficult to use with superficial carcinomas: 9 out of 12 could not be classified. Among invasive cancers only 1.5% were not classified in one of the two types. Polypoid and fungating carcinomas were more often of the expansive type (70.1%). On the contrary infiltrative carcinomas (ulcerated or not) corresponded to the infiltrative type of Ming in 65.6%. It was not possible to extrapolate the WHO classification to the Ming classification. Infiltrative carcinomas were more often associated with hyperplastic stroma (38.1%) than did expansive carcinomas (5.2%) the proportion of carcinomas limited to the digestive wall was higher in the expansive type (21.7%) than in the infiltrative type (5.0%). The survival rate was better in the expansive type (41.4%) than in the infiltrative type (30.1%) but the difference was not significant. The prognosis depended partly on the time of diagnosis. The results suggest that Ming classification has an epidemiological interest. It allows us to distinguish two types of carcinomas that appear quite different on basis of their growth and penetration capacity. However its prognostic interest appears limited.

Adult↗
PubMed1985

A proposal for a new TNM classification of esophageal carcinoma. Japanese Committee for Registration of Esophageal Carcinoma.

The TNM classification of malignant tumors is known to reflect the prognosis well and is being used widely in many countries. For TNM classification of the esophagus, we present a new one which has been modified according to the Japanese Guidelines for Esophageal Carcinoma. The new T classification is based on the depth of the invasion of the tumor. The new N contains metastasis not only to the mediastinal nodes but also to the perigastric nodes. We collected data on 3,211 patients with carcinoma of the thoracic esophagus during the period 1969 to 1978 in Japan. These patients were examined according to the present and new TNM classifications. The results of the study show that the new classification has a better correlation with the survival rates, and new T and new N are easily estimated by clinical examination.

Carcinoma↗
PubMed1977

[Moder classification of dermatophytes].

Dermatophytes are classified according to two systems. The first, or parasitic classifications of Sabouraud, rests on the morphology of the dermatophytes on the hair in vivo (Achorion, Trichophyton endothrix or ectothrix microides and megaspores, Microsporum) or on the absence of growth on the hair in vivo (Epidermophyton). In the second type they are classified according to their saprophytic morphology. There are many classification of this type based on the asexual state of the dermatophytes, e.g. the classification of Emmons (Trichophyton, Microsporum, Epidermophyton) or the classification of Vanbreuseghem and De Vroey (Microides, Trichophyton, Microsporum, Epidermophyton, Keratinomyces). As the existence of a sexual state of the dermatophytes has been demonstrated, the dermatophytes are also classified in two perfect genera: Arthroderma and Nannizzia. In this paper it is assumed that both classification have to be used because they are not correlated.

Arthrodermataceae↗
PubMedDate not supplied

A new morphological concept and classification of granulomatous inflammation: the polar granulomas.

An historical analysis of granulomas and a new morphological concept and classification of granulomatous inflammation, the polar-granulomas, are presented. The historical analysis of the concept of granulomas reveals that the still proclaimed confusion concerning the process was due more to Virchow's comparison of granulomas to ordinary granulation tissue than to tumors and to objections of pathologists to Metchnikoff's theory of phagocytosis. And it is strange to verify that differences between granulomas and granulation tissue, although already established in the end of the 19th Century, were overlooked by the majority of pathologists. In this Century , the knowledge of granulomatous inflammation was greatly improved by Aschoff 's concept of reticulum endothelial system, Mitsuda test for types of leprosy, Jadassohn- Lewandowsky law, South American classification of leprosy into polar forms, and Forbus contribution to histogenesis and morphological classification of granulomas. The best model for the study of granulomatous inflammation is leprosy, because this disease is characterized by two different clinical polar forms, each one having particular types of phagocytosis (complete or incomplete) and of granulomas (tuberculoid or non tuberculoid). Based on the phenomenon of phagocytosis, polar forms of leprosy, Jadassohn- Lewandowsky law, metamorphosis of macrophages and nature of the etiologic agent, granulomas can be defined as a reactional hyperplasia of macrophages towards inanimate agents and towards animate agents of low virulence. Also based in the same data, a morphological classification of granulomas into polar types, tuberculoid and non tuberculoid, is proposed. The polar tuberculoid type follows the Jadassohn- Lewandowsky law, its etiologic agent is absent or scarce (complete phagocytosis) - and comprise two sub-types: tubercle-like and sarcoid-like. The polar non tuberculoid type does not follow the Jadassohn- Lewandowsky law, its etiologic agent is always present or copious (incomplete phagocytosis) and comprises two sub-types: giant cell and persistent macrophage. In the latter case, macrophages behave as a culture medium cell or as a storage cell. When both polar tuberculoid and non tuberculoid structures are found together in the same disease, granuloma can be called interpolar . If both types occur simultaneously in the same disease, granuloma would be bipolar. It seems that the proposed definition of granulomas combines morphology with functional activity of macrophages, easily observed in routine histopathological examination by optical microscopy. This morphological classification into polar granulomas (ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis, Differential↗
PubMed1983

Non-Hodgkin's lymphomas. Analysis of 92 cases using the 'international' classification.

Ninety-two non-Hodgkin's lymphomas in which cell-surface-marker studies were done were classified according to the "international" classification. Relationships among immunologic phenotypes and classification categories were evaluated. Although several categories were homogeneous for immunologic cell type, others were heterogeneous. The latter were found among the diffuse lymphomas and especially those of mixed-cell type. No histological feature other than a follicular architecture, proved to be specific to or exclusive of B, T, or non-B-non-T tumors. Since adequate diagnostic classification requires both morphological classification and immunologic classification based on cell-surface-marker techniques, provision for such studies should be made in the case of any biopsy specimen in which malignant lymphoma is suspected. Such studies may also assist in distinguishing large-cell lymphoma from undifferentiated carcinoma and malignant lymphoma from atypical lymphoproliferative processes.

Aged↗
PubMed1984

Classification of childhood psychopathology: a developmental perspective.

The absence of a comprehensive, objective, and reliable system for classifying emotional and behavior problems in children has slowed the advancement of knowledge in the field of developmental psychopathology. This paper provides a developmental framework for the classification of psychopathology in children and highlights the potential contributions that such classification may have toward the understanding of normal development. The salient issues derived from this developmental perspective are concerned with the continuity between childhood and adult psychopathology, and the definition of normality and adaptation in the context of development. The implications of the continuity issue for classification are that (a) the validity of adult criteria for use with children should be explored further, (b) the diagnosis of a childhood disorder at 1 point in time is not necessarily dependent upon there being episodes of the disorder at a later time, and (c) the focus of classification should not be limited to isolated behaviors and traits, but rather should emphasize patterns of adaptation. Moreover, it is suggested that judgments about normality and dysfunction should be made relative to what is expected given the child's age, sex, environmental context, developmental task, level of functioning, and phase in the progression through development. This paper provides a conceptual framework that will facilitate the construction of a more developmentally relevant system of classification.

Child↗
PubMed1982

The classification of anxiety and hysterical states. Part I. Historical review and empirical delineation.

The history of the classification of anxiety, hysterical, and hypochondriacal disorders is reviewed. Problems in the ability of current classification schemes to predict, control, and describe the relationship between the symptoms and other phenomena are outlined. Existing classification schemes failed the first test of a good classification model--that of providing categories that are mutually exclusive. The independence of these diagnostic categories from each other does not appear to hold up on empirical testing. In the absence of inherently mutually exclusive categories, further empirical investigation of these classes is obstructed since statistically valid analysis of the nominal data and any useful multivariate analysis would be difficult if not impossible. It is concluded that the existing classifications are unsatisfactory and require some fundamental reconceptualization.

Agoraphobia↗
PubMedDate not supplied

[Classification of viruses by computer].

The study used the information mass containing information on 83 viruses characterized by 41 markers. The suitability of one of the variants of cluster analysis for virus classification was demonstrated. It was established that certain stages of automatic allotment of viruses into groups by the degree of similarity of their properties end the formation of groups which consist of viruses sufficiently close to each other by their properties and are sufficiently isolated. Comparison of these groups with the classification proposed by the ICVT established their correspondence to individual families. Analysis of the obtained classification system permits sufficiently grounded conclusions to be drawn with regard to the classification position of certain viruses, the classification of which has not yet been completed by the ICVT.

Bacteriophages↗
PubMed1981

The international histological classification of tumours.

This article reviews the development of the WHO project on the histological classification of tumours, which has included the establishment of several collaborating centres and has involved more than 300 pathologists in over 50 countries. The project has resulted in the publication, over the last 14 years, of 25 volumes in the first series of the International Histological Classification of Tumours (IHCT), each giving a classification of tumours specific to a certain site. The classifications are based primarily on the microscopic characteristics of the tumours and are concerned with morphologically identifiable cell types and histological patterns as seen by means of light microscopy and conventional staining techniques. The article also describes the relationship between IHCT and other classification and coding systems and assesses possible future developments that may result from new approaches to diagnosis.

Humans↗
PubMed1978

Use and abuse of electrocardiographic classification systems in epidemiologic studies.

An analytical study is performed to examine the utility of the Minnesota Code ECG classification for estimation of the prevalence and incidence of coronary and hypertensive heart disease. A statistical model is introduced which permits comparative analysis of the contribution of human coding errors to the overall fraction of misclassified records. It is demonstrated that the poor sensitivity and visual coding variability can seriously limit the usefulness and obscure the meaning of ECG coding results if the disease prevalence or annual event incidence is low. Gross over- or underestimation of prevalence and incidence data takes place frequently. Occasionally, reasonably good estimates are made on the basis of false evidence, for instance when false classifications 'compensate' for a high miss rate. Visual classification errors may contribute a substantial fraction to the overall misclassifications. It is pointed out that the traditional method of estimating classification errors by repeated coding of a given set of records gives a false impression of coding reliability. It is concluded that a substantial reduction of coding variation and an overall improvement of diagnostic accuracy will be required in order to justify continued use of ECG classification in population studies.

Computers↗
PubMed1981

The determination of alternative hospital classifications.

The problem of determining alternative hospital classifications when explicit constraints are recognized in the classification process is discussed. It is argued that such constraints are an integral part of most hospital classification processes and should be handled directly. A methodology based on cluster analysis, which can directly accommodate any number of specific constraints that might be imposed on the classification process, is described. A number of these possible constraints are presented. To illustrate the process, the methodology is applied to a data set of 200 short-term general hospitals; empirical results are presented that demonstrate the potential effects of various constraints on the hospital classification process.

Hospitals↗
PubMedDate not supplied

[Classification of nematode parasites of vertebrate animals].

The authors give the analysis of the best known systems of nematodes, parasitizing vertebrates. The classifications of Chitwood (1933, 1937); Skrjabin et Schultz (1940) and Chabaud (1974) are discussed. A new variant of the system of the mentioned nematode groups is proposed, the classification of Chabaud being assumed as its basis. In the subclass Adenophorea the authors distinguish two orders--Trichocephalida and Dioctophymida. The subclass Secernentea includes according to Chabauds system five orders: Rhabditida, Strongylida, Oxyurida, Ascaridida and Spirurida. Two suborders--Ascaridina and Heterakina are distinguished in the order Ascaridida, three suborders--Spirurina, Cammallanina and Filariina--in the order Spirurida. The suborders Gnathostomatina and Cucullanina are admitted to be not enough valid. Both these groups are considered as superfamilies in the new variant of classification. A conception of the close phylogenetic relationships between the orders of the subclass Seurina, Cammallanina and Filariina--in the order Spirurida. The suborders Gnathostomatina and Cucullanina are admitted to be not enough valid. Both these groups are considered as superfamilies in the new variant of classification. A conception of the close phylogenetic relationships between the orders of the subclass Seurina, Cammallanina and Filariina--in the order Spirurida. The suborders Gnathostomatina and Cucullanina are admitted to be not enough valid. Both these groups are considered as superfamilies in the new variant of classification. A conception of the close phylogenetic relationships between the orders of the subclass Secernentea is championed. The authors believe that the historical development of the representatives of this nematode group occurred from the rabditiform worms towards the strictly specialized parasitic forms, which are met in the order Spirurida. The representatives of the order Rhabditida are the most closely related to the ancestral forms of the subclass Secernentea.

Animals↗