[100 years German Society of Pathology. Comments on the contribution by G. Dhom].
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Biomedical subjects
Publications and source records attributed to H Zschoch.
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Between 1984 and 1987, autopsies were performed on 214 decreased who were safely assumed to have been chronic consumers of alcohol. Histological investigations were conducted on 84 ureters, with twelve of them (14.3 percent) exhibiting capillarosclerosis. This statistical relationship between alcohol consumption and capillarosclerosis was not attributable to action of alcohol on the capillaries but most probably had been a consequence of polytoxicomania, e.g. chronic alcohol abuse in concomitance with intake of phenacetin-containing medicaments. Accidental post-mortem finding of capillarosclerosis may be interpreted as a relative indicator to chronic alcohol consumption.
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Reported in this paper is a case of a woman, 21 years of age, with intraductal mammary papillomas of unusual sclerogenicity, accompanied by fibrocystic disease of the breast.
Analysis of 311 death certificates issued on stillbirths and deaths below one year of age, between 1979 and 1984, together with checks on all clinical data in them revealed a great number of erroneous entries by pathologists. These included using of wrong printed lines, reference to wrong ICD classes, disagreement between verbal notes and ICD code, statement of unimportant changes as causes of death, and mistakes in defining basic diseases. Error rates are reported and discussed. Pathologists quite often failed to take sufficient advantage of the possibility of stating a multicausative background of death.
After having described the beginnings of documentation and statistics of causes of death of newborns and children the development of this branch of medical statistics in the GDR and the introduction of a special death certificate in 1961 is dealt with. To help obstetricians, perinatologists and pediatrists to tackle the problem of documentation of the causes of death of stillborns and newborns the 9th revision of ICD, the nowadays valid death certificate and special rules of signing are explained to avoid mistakes, which are often met with in the daily practice.
The analysis of 311 death certificates of stillbirths and live born under one year of age covering the period from 1979 to 1984 and the analysis of the clinical dates referring to revealed: a high frequency of mistakes both in the nondiagnostic and in the diagnostic part, the handling of the documents was not in correspondence with the law, the number of mistakes in the nondiagnostic part has decreased, obstetricians made more mistakes than pediatrists, physicians with great experience in the field of death certificates made less mistakes, the number of secundinae to be morphologically investigated was to low and the possibility of corrections of the cause of death was not made use of. To improve the situation recommendations are given.
The analysis of 311 death certificates of stillbirths and dead persons under one year revealed a lot of mistakes both in the diagnostic and nondiagnostic part of the form. All mistakes are mentioned and discussed. 90% of the death certificates had been written out by obstetricians and pediatrists, but also pathologists made many mistakes. It is recommended to perform a training referring hereto for obstetricians, pediatrists, neonatologists, pathologists and specialists in forensic medicine on the one hand and to combine the various rules printed in the pocket- and handbook of ICD and in the interpretations of LEOPOLD and HUNGER on the other.
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The first prospective investigation of thyroid weights of over 20 years old adults in the GDR is presented. The material is based on autopsy findings from the Brandenburg area before using salt with iodine. Judging by the results this area appears as an endemiological one. Relationships to iodine content of drinking water, comparisons with autopsy statistics of other countries, and the role of regional epidemiological differences are pointed out. The importance of the investigation for patients care and the possibility of controlling the effect of using salt with iodine is underlined. The examination of relations between thyroid weight and anthropometric data showed no additional results.
Ichthyosis uteri--total squamous cell metaplasia of the uterine cavity--is a rare finding. Its pathogenesis as well as the evaluation of its malignant potential are discussed, and two new cases are described.
The following conclusions were drawn from analysis of 292 specimens of amputated female breasts and statistical evaluation of the clinical data: Preparation of lymph nodes from unfixed material should be left to medical preparation engineers. All data on sizes and numbers should be recorded for documentation with high accuracy. Communication of clinical data has often been insufficient. It has happened all too often that no diagnostic extirpation was undertaken, and the time interval between such extirpation and radical surgery was found to be too long in some hospitals.
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