Juan Rosai: la pasión por el diagnóstico y nuestro encuentro en España / Juan Rosai: the passion for diagnosis and our meeting in Spain

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Simulación médica en punción aspiración con aguja fina utilizando maniquíes. Experiencia docente universitaria / Medical simulation training in fine needle aspiration cytology using phantoms. University teaching experience

Introducción. La punción aspiración con aguja fina (PAAF) es un procedimiento diagnóstico mínimamente invasivo y extremadamente útil para tipificar lesiones. La limitación de medios en las prácticas de anatomía patológica ha dificultado su enseñanza. Describimos la incorporación de maniquíes diseñados para realizar PAAF en nuestro centro. Material y métodos. Los maniquíes consisten en 2 simuladores de tareas, artesanales y a tamaño natural, de las regiones facial/cervical (modelo de utilidad U201500372) y de torso, respectivamente, revestidos por silicona, simulando piel, con áreas tumorales. Permiten realizar PAAF (palpación, punción, aspiración, obtención de material y extensión sobre portaobjetos) y son reutilizables. La práctica se realizó durante 3 cursos académicos (2013-2016) y consistió en realizar PAAF de manera individualizada sobre contexto clínico, con ulterior correlación citológica. Resultados. Un total de 178 estudiantes de medicina de la Universidad de Murcia de tercer curso realizaron la práctica (28 grupos: 105 mujeres, 73 hombres). La tasa de acierto (punción, aspiración de material y extensión en portaobjetos) fue del 97,2% con la primera punción. Además, 13 estudiantes procedentes de otras 10 universidades (nacionales e internacionales) llevaron a cabo la práctica, refiriendo la no existencia en sus centros de procedencia. Fue considerada como de gran valor sobre encuesta anónima. Discusión. Las prácticas de PAAF son fácilmente implementables y potencialmente incorporables a los formatos evaluativos tipo examen clínico objetivo estructurado (ECOE). No existe una adecuada estandarización en las prácticas de diferentes centros universitarios. Las prácticas de PAAF mejoran la formación del estudiante y proporciona un mayor conocimiento y una mejor consideración de nuestra especialidad (AU)

Background. Fine needle aspiration cytology (FNAC) is a minimally invasive and extremely useful procedure. The characteristics of the practice of pathology, together with limited equipment, make teaching this technique difficult. We therefore have introduced phantoms designed to perform FNAC as part of the medical education programme in our hospital. Material and methods. Phantoms are two life-sized hand-made reproductions of an adult head & neck (utility model ES1140059) and a trunk, respectively, coated with silicone simulating skin and with inserted tumor areas. They allow the whole FNAC process (palpation, puncture, aspiration, placement of material on slide and smear preparation) to be performed and, furthermore, are reusable. During 3 academic years (2013-2016) FNAC samples have been obtained in this way by each student individually, in a clinical context and with subsequent cytological correlation. Results. A total of 178 third year medical students from the University of Murcia, Spain, took part in the FNAC training programme (28 groups: 105 women, 73 men). The success rate in the first attempt (puncture, aspiration of material, placing and extending the obtained material on slides) was 97.2%. Furthermore, 13 students from 10 other universities (national and international) also took part, not having such a programme in their medical schools. In an anonymous survey the consensus was that it was valuable practical training. Discussion. Training in FNAC techniques is easy to include in the undergraduate curriculum and also in the Objective Structured Clinical Examination (OSCE) evaluation format. There is no proper standardization in training among different universities. FNAC simulation provides students with greater knowledge and appreciation of our specialty (AU)

Pathology in Greece.

Pathology is the field of medicine that studies diseases. Ancient Greece hosted some of the earliest societies that laid the structural foundations of pathology. Initially, knowledge was based on observations but later on the key elements of pathology were established based on the dissection of animals and the autopsy of human cadavers. Christianized Greece under Ottoman rule (1453-1821) was not conducive to the development of pathology. After liberation, however, a series of events took place that paved the way for the establishment and further development of the specialty. The appointment in 1849 of two Professors of Pathology at the Medical School of Athens for didactical purposes proved to be the most important step in fostering the field of pathology in modern Greece. Presently in Greece there are seven university departments and 74 pathology laboratories in public hospitals, employing 415 specialized pathologists and 90 residents. The First Department of Pathology at the Medical School of Athens University is the oldest (1849) and largest in Greece, encompassing most pathology subspecialties.

A history of radiologic pathology correlation at the Armed Forces Institute of Pathology and its evolution into the American Institute for Radiologic Pathology.

The evolution of the Armed Forces Institute of Pathology (AFIP) has played an important role in the history of pathology education and in radiologic pathology correlation in the United States. From its humble beginnings as a museum, showcasing dried and varnished morbid specimens--human relics of the Civil War, the institute became a leader in pathology. Later, it became a center of instruction for radiology residents seeking to understand the pathologic findings that underlay the radiologic appearance of disease. Images were gathered by the AFIP and the American Registry of Pathology (ARP) and have been used in research and education in radiology and other fields (ophthalmology, otalaryngology, dermatology, obstetrics and gynecology, and surgery). Despite the contributions of the AFIP, the ARP, and the Radiologic Pathology Correlation Course, high-ranking members of the military and the federal government frowned on a military-owned educational system that also served civilians. Although support from the radiology community dissuaded military officers and federal officials from taking action against the participation of civilians, the 2005 Base Realignment and Closure (BRAC) provisions mandated the disestablishment of the AFIP, forcing the redistribution of some of its resources to other military-only organizations and disbanding other AFIP functions. To ensure that the correlation course, known to radiology residents as the "rad-path" course, was not a casualty of the BRAC, the American College of Radiology (ACR) and leaders of the AFIP and ARP agreed that the ACR should continue this vital educational endeavor. In January 2011, the American Institute for Radiologic Pathology of the ACR debuted and successfully instructed 268 radiology residents, including 40 international residents. The faculty and staff, who had been part of the course at the AFIP, continue to help enrich and improve the course established by their predecessors.

The Warrens and other pioneering clinician pathologists of the Massachusetts General Hospital during its early years: an appreciation on the 200th anniversary of the hospital founding.

To celebrate the bicentennial of the 1811 charter to establish the Massachusetts General Hospital, we tell the stories of the physicians and surgeons of the hospital who practiced pathology until the discipline was more firmly established with the recruitment of James Homer Wright who became the first full-time pathologist at the hospital in 1896. One of the two co-founders of the hospital, John Collins Warren (famed primarily for being the surgeon at the first public demonstration of ether anesthesia) had a major interest in pathology; he published a book focused on gross pathology (1837) and began the important specimen collection subsequently known as the Warren Anatomical Museum at Harvard Medical School (HMS). An early physician, John Barnard Swett Jackson, became the first professor of pathology in the United States (1847) and was a noted collector whose specimens were added to the Warren Museum. Dr Jackson showed no interest in microscopy when it became available, but microscopy was promoted from circa the late 1840s at Harvard and likely at the hospital by Oliver Wendell Holmes, the famed essayist who was on the staff of the hospital and faculty at the medical school. Microscopy was probably first used at the Hospital with any frequency on examination of fluids by the first officially designated 'Microscopist,' John Bacon Jr, in 1851, and after the mid-1850s by Calvin Ellis on anatomic specimens; Ellis went on to pioneering reform of the HMS curriculum. Reginald Heber Fitz succeeded Ellis in 1871 and was the first to be officially designated as 'Pathologist' at the hospital. Fitz is remembered for two major contributions: his paper showing the nature of, and potential surgical cure for, the disease that he termed 'appendicitis'; and his description of acute pancreatitis. With the microscope now firmly entrenched and with the increase in surgery after Fitz's work on appendicitis, surgical pathology grew quickly. J Collins Warren, the grandson of the co-founder, had a major interest in pathology and in 1895 published an impressive volume entitled 'Surgical Pathology and Therapeutics.' Dr Warren had a major interest in breast disease and was a pioneer of needle biopsy in the evaluation of breast masses. In 1888, William Fiske Whitney joined the staff of the hospital and spent his nearly 30-year career practicing primarily as a surgical pathologist, making particular innovations in intraoperative consultation. The contributions of these individuals brought the field from a gross pathology-oriented discipline mostly oriented around teaching to a microscopy-dependent practice integral to patient care, and hence set the stage for the formal founding of the Pathology department in 1896.

[90th anniversary of the Chair and Department of Forensic Medicine Poznan University of Medical Sciences]. / 90-lecie Katedry i Zakladu Medycyny Sadowej Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu.

The paper outlines the history of the Chair and Department of Forensic Medicine Poznan University of Medical Sciences since it was established until today. Changes in the appearance and organization of the seat of the institution were discussed briefly. The profiles of all former heads of the Department, their contribution to the development and improvement of the institution and formation of the new scientific forensic medicine staff were presented. The specification and analysis of the scientific staff achievements was performed, especially taking into account their scientific publications and scope of the research that contributed to the efficient service activities for the prosecution and police, as well as society.

Historical development of the renal histopathology services in Malaysia.

Western-style medicine was introduced to Malaya by the Portuguese, Dutch and British between the 1500s and 1800s. Although the earliest pathology laboratories were developed within hospitals towards the end of the 19th Century, histopathology emerged much later than the biochemistry and bacteriology services. The University Departments of Pathology were the pioneers of the renal histopathology diagnostic services. The Department of Pathology, University of Malaya (UM) received its first renal biopsy on 19 May 1968. Hospital Universiti Kebangsaan Malaysia (HUKM) and Hospital Universiti Sains Malaysia (HUSM) started their services in 1979 and 1987 respectively. It is notable that the early services in these University centres caterred for both the university hospitals and the Ministry of Health (MOH) until the mid-1990s when MOH began to develop its own services, pivoted on renal pathologists trained through Fellowship programmes. Currently, key centres in the MOH are Kuala Lumpur Hospital, Sultanah Aminah Hospital Johor Bahru and Malacca Hospital. With the inclusion of renal biopsy interpretation in the Master of Pathology programmes, basic renal histopathology services became widely available throughout the country from 2000. This subsequently filtered out to the private sector as more histopathologists embraced private practice. There is now active continuing professional development in renal histopathology through clinicopathological dicussions, seminars and workshops. Renal research on amyloid nephropathy, minimal change disease, IgA nephropathy, fibrillary glomerulonephritis, lupus nephritis and microwave technology have provided an insight into the patterns of renal pathology and changing criteria for biopsy. More recently, there has been increasing involvement of renal teams in clinical trials, particularly for lupus nephritis and renal transplant modulation.

[Twenty years' experience with the information system "biopsy" used in the work of a department of morbid anatomy].

The long-term use of the information system "Biopsy" has shown its efficiency in improving the organization of the department of morbid anatomy in a large hospital. Its advantages are the availability of materials and necessary information for the shortest period. The introduction of an electronic signature and the storage of signed documents are new real steps to the creation of paper-free technology, including the so-called electronic case history base. Automated exchange of orders for tests and their results not only reduces the time of their obtaining, but also lowers costs and enhances the efficiency of work pf a biopsy laboratory.

[Ophthalmopathology between yesterday and tomorrow]. / Ophthalmopathologie zwischen gestern und morgen.

As financial resources run short there are considerations to integrate the ophthalmopathological laboratories of the eye hospitals into the institutes for pathology. The term "return" which is used sometimes in the discussion is historically incorrect as the pathology of the eye--similar to dermatopathology in the clinics for dermatology--was developed quite independently from general pathology in the eye hospitals over the last 150 years. Due to the work of outstanding ophthalmologists like Otto Becker, Theodor Leber, Julius Michel, and Ernst Fuchs ophthalmopathology augmented the ophthalmological knowledge much more than any other subdiscipline in the late 19th and the early 20th century. At any time, the very close link of the clinical picture and the morphology proved to be very advantageous for the understanding of the diseases. As a consequence of new diagnostic tools and progress in therapy the pathology of the eye is always changing and it is a still very important motor of modern ophthalmology. Whether in the clinical or in the experimental field: classical ophthalmopathology serves to characterise the phenotype, and nothing indicates that genomics or proteomics will make it unnecessary within the foreseeable future. Pure diagnostic pathology of the eye does not cover the costs. However, there are enough good reasons to keep the ophthalmopathological laboratories as parts of the eye hospitals.

[50th anniversary of the Department of Forensic Medicine, Medical University of Bialystok (1954-2004)]. / 50-lecie Zakladu Medycyny Sadowej Akademii Medycznej w Bialymstoku (1954-2004).

The paper illustrates the history, scientific and teaching achievements of the Department of Forensic Medicine, Medical University of Bialystok in commemoration of its 50th Anniversary.

[Prof. Maria Byrdy--Doctor Honoris Causa AMB 1990, the founder of the Chair of Forensic Medicine, the first head of the Department of Forensic Medicine, Medical University of Bialystok in 1954-1984]. / Prof. dr maria byrdy--doktor Honoris Causa AMB 1990 r., zalozycielka katedry medycyny sadowej, pierwszy Kierownik Kakladu Medycyny Sadowej AM w Bialymstoku w latach 1954-1984.

The paper portrays the scientific, publicist and teaching activities of Prof. M. Byrdy, with special regard to her residence at the Departments of Forensic Medicine in Cracow (1939-1953) and Bialystok (1954-1984).

[Thirty years of breast pathology in an anticancer center]. / Trente ans de pratique en pathologie mammaire dans un centre anti-cancéreux.

Looking back to three decades of professional experience allows to evidence the dramatic changes of the role of the pathologist in breast cancer clinical management. Increasing means, fruitful exchanges within pathologists, and closer collaborations with other specialists have been key mediators of this evolution.

[30 years work of the autopsy department of a city general hospital]. / 30 let raboty prozektury gorodskoi mnogoprofil'noi bol'nitsy.

The paper reports the analysis of the activity of the pathology department at Moscow general hospital N 67 with the emphasis on autopsy and biopsy investigations, research activity. Such analyses are thought useful both for intrahospital and health service use.