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1. The history of child pathology is derived from the description of the development of the an pathological anatomy and paediatry. 2. The pathological anatomy of infancy is basing on the research results of the general and special pathology, the pathological physiology and the clinical medicine by the help of the experiment and the knowledges of biology, chemistry, and physics. 3. Further decisive impulses are given by social medicine.
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.
The two goals of osteoplastic trepanation of the middle ear spaces are first a direct inspection of the main areas of pathologies within the epitympanum and secondly a better understanding of the infected middle ear diseases through careful preparation and exposure of the pathologic processes. A new way of approval could be found by taking into account the anatomical and topographical realities and the possible deviations form normal cases. This opens a better understanding of all those variations. Without touching the microstructures of the tympanum their inspection and preparations are hereby made possible macro- and microscopically. This leads to the conclusion that the tympanic structures are involved in the formation and progression of infected middle ear diseases. The correlation of the "aeration pathways" and the "drainage outlets" of the middle ear as an interdepending functional unit can be seen by this new intrasurgical inspection-based on light- and electronic microscopic research of various authors-as well as through the fact that middle ear mucous membrane is a truly respiratory membrane with no difference to other aeration pathways as found in the nose. A of a summation of mucous membranes in the area of the diaphragma is that minor catarrhal inflammations will block this aeration pathway of the middle ear. At the same time an open tuba auditiva can be found in acute, subacute and chronic middle ear diseases. Our findings that the ventilation of the ear is in most cases blocked at the diaphragma and not at the tube leads to questions on the one hand regarding the function of diaphragma and to the opinion on the other that the ventilation system of the middle ear is divided in two sections by the diaphragma: An anterior section including tuba and hypomesotympanon and a posterior including epitympanon, aditus, antrum and the pneumatic cells of mastoid and pyramid. The anterior section still is ventilated through the tuba when blocked at the diaphragma, in the posterior one ventilation and drainage are blocked even by mildly infected processes. Longer lasting infections have severe consequences for these spaces and the tympanic membrane.
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Fifty-seven thymomas, defined as neoplasms of the epithelial-reticular framework cells of the thymus, were assessed in respect to histologic type, inclusive of there ultrastructural aspects. The median age of the 57 patients was 40.4 years, with a range of 2 1/2--72 years. All neoplasms were located in the anterior mediastinum. The tumours in 40 cases were encapsulated and without invasion of adjacent tissue or implants (equal to non-invasive thymomas). The tumors in 17 cases were invasive of adjacent tissue, particularly mediastinal pleura, pericard and trachea. Six of 57 patients (equal to 10.5%) with thymomas have had a thoracic and supraclavicular lymph node metastasis, and osteolytic metastases in the vertebrae and sternum. Thirty-seven (equal to 64.9%) were so-called lympho-epithelial, 7 (equal to 12.3%) pure epithelial, 4 (equal to 7.0%) atypical (or anaplastic) with granulomatous focuses, 3 (equal to 5.3%) carcinoid and one (equal to 1.8%) seminomatous tumors. One patient have had a thymic cyst as a tumor-like conditions of the thymus, and four patients (equal to 7.0%) have had a thymo-lipoma. The histologic type of thymoma had no proof value in predicting prognosis with the exception of the so-called atypical or anaplastic thymoma. The fine structural aspects of thymomas and the fine structural differential diagnosis of anterior mediastinal tumors are discussed.
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Histopathological investigation of the vascular changes in Kawasaki disease was carried out on thirty-seven autopsied Japanese patients. Arterial lesions could be classified into following five stages from the view point of morphogenesis of arteritis; 1) endothelial degeneration and increased vascular permeability, 2) edema and degeneration of the media, 3) necrotizing panarteritis, 4) granulation formation, and 5) scarformation. Aneurysm with thrombus was observed mainly in the coronary artery in most patients. It is considered that the initial changes begins in the endothelial cells with increased vascular permeability. Platelet aggregation in the damaged endothelial cells seems to play an important role in the further development of the arteritic changes. Vascular lesions were observed not only in the arterial system but also in the venous system, therefore Kawasaki disease is a systemic vasculitis rather than a systemic arteritis.
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By opposition to acute post-operative ischaemic enterocolitis, the authors isolate, with the aid of seven cases, the intestinal lesions which spontaneously occur on the small intestines and on the colon and due to an ischaemic mechanism without thrombosis of the mesenteric vessels. After the description of clinical and anatomical features, they point out the main part of the vascular factor in the genesis of the lesions.