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PubMed2002

[The future of pathology--from the viewpoint of clinical pathology].

Pathology is one of the fundamental diagnostic fields of medicine, its position has changed and will undergo transformation in the 21st century due to the introduction of new methods. Theoretically, pathology was based upon 3 pillars: 1. the autopsies, 2. the surgical pathology, i.e. the processing and evaluation of different biopsies and surgically resected specimens and 3. the cytological investigations. The autopsy was the dominant field till the end of the seventies of the 20th century but about the turn of the 20th and 21st century the cytology, first of all the fine needle aspiration cytology took over the leading role in the pathologic diagnostic activity. This displacement resulted in such a high decrease in the number of autopsies that it is impossible to conclude appreciable epidemiological statements. Meanwhile the role and position of the pathologist has changed also substantially. Previously he was regarded often as a prosecuting attorney. At present time this opinion is transformed into clinical pathologist. Errors in the histopathological diagnosis and reporting can occur in the surgical pathology but its number is not high. To detect and to avoid them is attainable by composition of an adequate audit-system. The number of the new investigatory methods is increasing nowadays wide-spreadingly in the medicine and so in the pathology too. The immunocytochemistry is regarded already as a conventional method but the PCR and FISH-technique are applied also on a large scale. At the same time, new tools such as the cDNA microarray technology, the micro-chip based analytical chemistry, the laser capture microdissection and the wireless medical information appear also in the pathology. The modern information technology is impacted more intensively into the day-to-day pathological work. This method enables to develop worldwide communicating systems which can make perfect the diagnostic work. The pathologist has traditionally functioned as a medical consultant to the clinician. The predominant function of the pathologist has to be evolved from that of medical consultant to that of information specialist.

Autopsy↗
PubMed2000

The role of the pathologist as tissue refiner and data miner: the impact of functional genomics on the modern pathology laboratory and the critical roles of pathology informatics and bioinformatics.

This article provides an overview of how functional genomics is likely to impact on the pathology laboratory and highlights how informatics and tissue banking will greatly facilitate the molecular age of medicine. Important aspects of functional genomics in the post-genome era, including the roles of laser capture microdissection, DNA- and complementary DNA-based microarrays, proteomic methods, collaborative human tissue banking, tissue microarrays, and pathobioinformatics in the modern pathology laboratory are discussed. The role of mass spectroscopy in the analysis of RNA, DNA, and protein and its impact on the clinical laboratory, particularly in cost-effectiveness and time savings, are evaluated. This article explores how laboratory information systems (LISs) and the devices that feed them information may need to be modified to adapt to greater volumes of data for the new testing modalities that require understanding sophisticated fluorescence detection methods and image processing. Emerging genomic testing methods and their impact on pathology laboratory testing, especially in the area of molecular classification of neoplasms, are examined. The role of the tissue bank in the modern pathology laboratory as an archive of control normal tissues, as well as subsamples of the spectrum of progressive neoplastic states, is discussed in light of its critical importance to the molecular classification of cancer. Establishing a database that combines structured reports in pathology LISs and construction of tissue banking information systems will provide a rich resource for pathology departments. The article discusses a hypothetical resource, such as the Shared Tumor Expression Profiler, that would provide access to well-characterized tissue-based research resources for clinicians and researchers. Last, the article emphasizes how LISs can prepare for these changes, and how training pathologists in pathology informatics and bioinformatics (pathobioinformatics) is critical to ensure pathology's overall leadership role in the post-genome era.

Clinical Laboratory Techniques↗
PubMedDate not supplied

Introduction: human pathology within the broad scope of comparative pathology.

Pathologic integration is the basic phenomenon of comparative pathology. Since man evolved as earth's most influential species, he was unequally influenced the progression and prevention of diseases in himself and other species. This has both positive and negative ramifications. Positive influences have been life-style, the prolongation of life under healthy conditions and medical progress as seen in the treatment of diabetes mellitus, dental hygiene and other factors, such as the decrease of infectious and parasitic diseases, which are still dominating factors in developing nations. Negative influences are side effects of medical treatments, the appearance of occupational, and certain recreational diseases. These are the pathologic effects of man's life-style to which car accidents, smoking and other factors can be added. Different species are affected by environmental changes such as pollution, ozone, acidic rain, polluted food, and transmission of different diseases from one species to another. Interspecies-specifically the direct influence of man in the extermination of other species, or the indirect influence such as through pollutants in the environment producing chain reactions in different species, can be distinguished. The physical environment has been changed as can be seen in air pollution in large cities, the damage to the ozone layer and the increase of malignant melanoma in certain regions of western Australia. The industrialized nations are dominated by non-infectious diseases such as atherosclerosis and neoplasms, whereas in the developing nations parasitic and infectious diseases stand in the fore-front. Particular diseases like acquired immunodeficiency syndrome increase in both types of nations. These diseases may have developed from other species, e.g. the plague which was originally a disease of rodents, especially rats where it was transmitted by the flea, Xenopsylla cheopis, Rothschild. The principle of foremost importance is the disruption of biologic integration of normal processes leading to different types of pathologic progression. A typical problem affecting man and many other fellow species is crowding. Man's pathology and the pathology of other species exhibit continued integration which is the central problem for understanding diseases where similar functions are performed by various structures, such as is the case in gaseous exchange, or differences in size and life span. The broad spectrum of comparative pathology which centers around human pathology provides a source of increased knowledge for a better understanding of diseases. The present issue is based on the two symposia organized by the International Society for the Study of Comparative Ongology during the Fifth International Conference of Anticancer Research, 17-22 October 1995, Corfu, Greece.

Animals↗
PubMed2000

Coexisting pathologies in the brain: influence of vascular disease and Parkinson's disease on Alzheimer's pathology in the hippocampus.

The finding of more than one coexisting brain pathology in dementia sufferers is not unusual. However, it is unclear how these different diseases may interact or influence the evolution of one another. In this study we analyse the hippocampal expression patterns of hyperphosphorylated tau, paired helical filament (PHF)-related protein, beta-amyloid and synaptophysin in a group of Alzheimer's disease (AD) sufferers with and without additional pathology. Compared to cases with only AD-type pathology we found that the presence of additional vascular disease augmented the accumulation of hyperphosphorylated tau in the CA1 region of the hippocampus without affecting PHF formation in cases with mild AD changes and reduced the extent of PHF formation in the CA2/3 and CA4 regions of the hippocampus in cases with severe AD pathology. We also found that synaptophysin immunoreactivity in the CA4 and dentate gyrus in pure AD was inversely related to the extent of amyloid accumulation but not to neurofibrillary pathology in the same regions. These relationships were lost when additional pathology was present. Memory scores obtained during life correlated closely with hyperphosphorylated tau and PHF-related protein expression in CA1 in pure AD but not in AD with additional pathology. Total amyloid and synaptophysin expression in the hippocampus did not correlate with memory scores in any patient group. Our findings suggest that the interactions of two pathologies in the hippocampus are complex and may differ depending on the stage reached in the evolution of a progressive disease such as AD.

Aged↗
PubMed2003

Tau pathology in the olfactory bulb correlates with Braak stage, Lewy body pathology and apolipoprotein epsilon4.

Olfactory dysfunction increases with disease severity in Alzheimer's disease (AD), is early and independent of disease severity in Parkinson's disease (PD), but is absent in progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). Previous histopathologic studies of olfactory bulbs in AD have shown neurofibrillary tangles (NFTs) and senile plaques while Lewy bodies (LBs) have been described in PD. Little is known about olfactory bulb pathology in PSP and CBD. Tau and alpha-synuclein pathology was assessed with immunohistochemistry in olfactory bulbs of AD (N=15), Lewy body disease (LBD; N=10), LBD with concurrent AD (AD/LBD; N=19), PSP (N=27), CBD (N=3) and cases with no significant neurodegenerative pathology (NSP; N=15). The Braak NFT stage, counts of senile plaques and NFT in cortical and hippocampal sections, and counts of LBs in amygdala and cortical sections were recorded for each case. Apolipoprotein E (APOE) genotypes were determined on DNA prepared from frozen brain tissue. All AD and AD/LBD cases and nine of 10 LBD cases had tau pathology in the anterior olfactory nucleus (AON), but it was uncommon in PSP (9/27), CBD (0/3) and NSP (5/15). Multiple linear regression analysis demonstrated that tau pathology in the AON correlated with Braak stage (P<0.001), cortical LB counts (P<0.001), as well as APOE epsilon4. Tau pathology is common in the olfactory bulb of AD and LBD but is minimal or absent in PSP and CBD. It correlates with APOE epsilon4, severity of tau pathology in the brain and surprisingly with cortical and amygdala LBs, suggesting a possible synergistic effect between tau and synuclein in the AON in cases with both pathologic processes.

Aged↗
PubMed1999

Goals and objectives for molecular pathology education in residency programs. The Association for Molecular Pathology Training and Education Committee.

Increasing knowledge of the molecular basis of disease and advances in technology for analyzing nucleic acids and gene products are changing pathology practice. The explosion of information regarding inherited susceptibility to disease is an important aspect of this transformation. Pathology residency programs are incorporating molecular pathology education into their curricula to prepare newly trained pathologists for the future, yet little guidance has been available regarding the important components of molecular pathology training. We present general goals for pathology training programs for molecular pathology education. These include recommendations to pathology residents for the acquisition of both basic knowledge in human genetics and molecular biology and specific skills relevant to microbiology, molecular oncology, genetics, histocompatibility, and identity determination. The importance of residents gaining facility in integrating data gained via nucleic acid based-technology with other laboratory and clinical information available in the care of patients is emphasized.

Communicable Diseases↗
PubMedDate not supplied

[Pathological gambling: a clinical and therapeutic-evolutive study of a group of pathologic gamblers].

Gambling dependence or pathological gambling is a psychiatric disorder, recognised as such by the North American Psychiatric Association since 1980. Since 1981 we are carrying out a treatment program for patients who suffer from pathological gambling at the Psychiatric Service of "Ramón y Cajal" Hospital. There is an individualized treatment for each patient and their inclusion in group therapy discussions. We present a descriptive study of the most representative socio-demographic, clinical and therapeutic-evolutive data of 46 patients following treatment in our program. All fulfill the diagnostic criteria of DSM III-R for pathological gambling. They were 37 males and 9 females, with an average age of 39 years. More than half of the patients (58%) were consumers of alcoholic beverages; the drug consumption index found was 4% and practically they all were smokers (87%). The excessive drinking and pathological gambling incidence found among family were 35% and 20% respectively. Our therapeutic results support the idea that pathological gambling is a treatable disorder. After an average of two years following treatment 46% of our patients stopped or notably reduced its impulse to gamble. The high incidence of alcohol or drugs consumption among pathological gamblers and their families suggest a biological and psychological relationship between pathological gambling and the classical addictive disorders.

Adult↗
PubMed1986

[Continuing eco-pathological survey: 4. Demonstration of pathologic associations in dairy cow stock: herd data].

Data concerning frequencies of 17 main diseases in 59 dairy farms from continual eco-pathological survey, are analyzed by classical regression test, principal components analysis and analysis of variance. Thirty-three statistical relations (positive simple correlations) are shown. Clinical mastitis and retained placenta are associated to nine diseases each, metritis, stillbirth and non-infectious foot disorders to six, dystocia and infectious foot disorders to four, pathology of calf and abortion to three, mammary edema and appetite disorders to two. Ovarian pathology, digestive disorders and teat lesions are "isolated", being associated to only one other disease. The pathological frequencies in dairy farms seem to change in the same way, indicating the existence of common risk factors, and leading to propose a global hygienic prevention. The pathological associations allow to definite some groups of dairy farms showing one or other dominant pathological complex. In the frame of our sample of dairy farms, two groups seem to be determined: one with calving disorders and calf pathology centred on retained placenta, the other with foot disorders, infectious and metabolic troubles, centred on mastitis, as dominant diseases.

Abortion, Veterinary↗
PubMed1996

European Centre of Pathology as a basis of progress of European pathology in the future.

Nowadays the time is ripe to create a European Centre for Pathology which could function as a stimulating pathological centre and office of the European Society of Pathology. The process of organizing the European Centre for Pathology is proposed in the form of brief considerations and outlines for scrutiny and analysis, followed by a thorough discussion. The creation of such a European Centre for Pathology, having no counterpart in the world of pathoanatomical practice, will undoubtedly be a powerful breakthrough in European Pathology.

Europe↗
PubMed2002

Group for research in pathology education online resources to facilitate pathology instruction.

BACKGROUND: The Group for Research in Pathology Education (GRIPE) is an organization of pathology educators whose purpose is to promote and facilitate excellence in pathology education. One important function of GRIPE is the maintenance of image and multiple-choice test question data banks. These resources have recently been made available online via the GRIPE Digital Library Web site. The purpose of the GRIPE Digital Library project was to develop an online searchable database that would facilitate access to the GRIPE resources for pathology education. DESIGN: The GRIPE image bank--containing approximately 3000 peer-reviewed gross and microscopic pathologic images along with textual descriptions--was linked with the GRIPE test question bank using Gossamer Thread's DBMan Web database management program. The search and display templates create a functional user interface that integrates images, image descriptions, and test questions into a single online digital library. Using any Web browser, faculty can access the GRIPE Digital Library and search for images and/or test items that can be used in teaching. RESULTS: In the first 18 months (February 2000 through July 2001), users at 40 GRIPE member institutions signed up and used the GRIPE Digital Library to perform more than 6000 individual searches and view more than 37500 images. These digital images were used to produce lectures and laboratory modules that were posted on Web pages and made available to students remotely. CONCLUSIONS: The GRIPE Digital Library provides a unique resource that can facilitate development of educational materials for pathology instruction and helps to fulfill the educational mission of GRIPE.

Computer Communication Networks↗
PubMedDate not supplied

[Experience at cooperation between the Moscow Municipal Center of Pathology Research and the Chair of Pathology of the Russian Medical Academy of Postgraduate Training].

Pathology service in Moscow, unlike in other cities of Russia, is not centralized and consists of 57 pathology departments of hospitals for adults and 5 departments of children hospitals of municipal subordination; 30 federal pathology departments of hospitals, 20 departments and laboratories of research medical centers and 5 pathology chairs of medical institutes. In spite of high professional levels of the pathologists, the lack of a centralized city service is a negative aspect. Cooperation between Moscow City Pathology Center and Chair of Pathology of Russian Medical Academy for Postgraduate Education illustrates positive trends to consolidation of Moscow pathologists.

Academies and Institutes↗
PubMed2001

[Molecular pathology: applications of molecular biology in pathological anatomy].

The rapid development of molecular biology techniques as well as recent progress in the understanding of genetic and molecular basis of human diseases have had enormous impact in the practice of clinical pathology. Since new diagnostic (molecular) tools are now available, the concept of Molecular Pathology is emerging. Molecular Pathology is defined by the use of molecular biology techniques and the type of specimens that are involved in its practice, basically ARN and ADN, extracted from cytological and tissue specimens. Although most methods used in molecular pathology and their applications are still under investigation and clinical validation they have great potential in several areas of pathological diagnosis, particularly on infectious and neoplastic diseases. Introduction of these techniques in pathology laboratories in our country should significantly enhance the diagnostic and research skills in the field.

Genetic Techniques↗