116 results on '"Pathology, Surgical trends"'
Search Results
2. A prospective cohort study of the impact of covid19 world pandemic on the management of emergency surgical pathology.
- Author
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Perea Del Pozo E, Aparicio-Sánchez D, Hinojosa Ramírez F, Pareja Ciuró F, Durán Muñoz-Cruzado V, Sánchez Arteaga A, Dios Barbeito S, and Padillo Ruiz FJ
- Subjects
- Databases, Factual, Emergencies, Humans, Outcome Assessment, Health Care, Pandemics, Postoperative Complications epidemiology, Prospective Studies, Spain epidemiology, COVID-19 epidemiology, COVID-19 prevention & control, Emergency Service, Hospital trends, Facilities and Services Utilization trends, Health Services Accessibility statistics & numerical data, Pathology, Surgical trends, Patient Acceptance of Health Care, Surgical Procedures, Operative trends
- Published
- 2020
- Full Text
- View/download PDF
3. Graves' disease insights from a review of the Johns Hopkins surgical pathology archive.
- Author
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Ippolito S, Piantanida E, Tanda ML, and Caturegli P
- Subjects
- Baltimore, Graves Disease history, Graves Disease surgery, History, 19th Century, History, 20th Century, History, 21st Century, Hospitals, Humans, Pathology, Surgical trends, Retrospective Studies, Thyroid Neoplasms pathology, Thyroid Neoplasms surgery, Thyroidectomy history, Thyroidectomy trends, Archives history, Biological Specimen Banks history, Graves Disease pathology, Pathology, Surgical history
- Published
- 2020
- Full Text
- View/download PDF
4. Preface: Current Trends in Neuropathology.
- Author
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Meredith DM
- Subjects
- Humans, Neuropathology methods, Pathology, Surgical methods, Neuropathology trends, Pathology, Surgical trends
- Published
- 2020
- Full Text
- View/download PDF
5. Practice Paradigms Before and After Introduction of the Diagnosis-Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP): an Institutional Experience.
- Author
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Katsakhyan L, Song S, Lepe M, Shojaei H, Montone KT, LiVolsi VA, and Baloch ZW
- Subjects
- Adenocarcinoma, Follicular classification, Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Pathology, Surgical standards, Pathology, Surgical statistics & numerical data, Pathology, Surgical trends, Retrospective Studies, Thyroid Cancer, Papillary classification, Thyroid Neoplasms classification, Young Adult, Adenocarcinoma, Follicular surgery, Practice Patterns, Physicians' standards, Practice Patterns, Physicians' statistics & numerical data, Practice Patterns, Physicians' trends, Thyroid Cancer, Papillary surgery, Thyroid Neoplasms surgery, Thyroidectomy statistics & numerical data
- Abstract
The recently adopted terminology of "Noninvasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP) reflects the indolent behavior of these tumors. In contrast to conventional papillary thyroid carcinomas, NIFTP can be managed conservatively. The purpose of this study was to investigate changes in surgical and pathologic practice patterns at our institution since the introduction of the NIFTP diagnosis in 2016. A retrospective analysis of all thyroid specimens received in our laboratory between January 2015 and April 2017 was performed. The final cohort consisted of 1508 thyroidectomy specimens from 1508 patients (1153 (76.5%) women and 355 (23.5%) men), of which 1011 (67%) were total thyroidectomies and 497 (33%) were partial thyroidectomies. There were 558 (69.2%) total thyroidectomies and 248 (30.8%) partial thyroidectomies performed prior to introduction of the NIFTP diagnosis and 453 (64.5%) and 249 (35.5%) total and partial thyroidectomies, respectively, after the change in nomenclature. Within a year following the initial use of this diagnosis, 67 NIFTP cases were identified (9.5% of all thyroidectomies), whereas compared with the year preceding it, malignant diagnoses decreased from 54.5 (439) to 44.6% (313), and the benign category remained unchanged from 44.5 (367) to 45.9% (322). For the entirely submitted 67 NIFTP cases, the mean number of blocks submitted was 14.7 (0.98 blocks/g); for malignant lesions 17.7 (0.92 blocks/g); and for benign lesions 16.6 (0.75 blocks/g). The results of our study suggest that NIFTP are encountered in almost 10% of thyroidectomies at our institution with expected shifts in cytology and surgical pathology diagnoses as a result of the change in nomenclature. During this time period, significant shifts towards less aggressive surgical management were not observed. All 67 NIFTP nodules were submitted entirely with no significant difference in the number of cassettes submitted for NIFTP nodules as compared with follicular variant papillary thyroid carcinoma (PTC), classic variant PTC, or follicular adenoma.
- Published
- 2020
- Full Text
- View/download PDF
6. Practical Topics and Updates in Renal Pathology.
- Author
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Hendricks AR
- Subjects
- Humans, Kidney Diseases pathology, Nephrology trends, Pathology, Surgical trends
- Published
- 2020
- Full Text
- View/download PDF
7. Breast cancer pathology reporting in the Indian context: Need for introspection.
- Author
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Desai SB
- Subjects
- Breast Neoplasms drug therapy, Breast Neoplasms surgery, Female, Humans, India, Medical Records, Specimen Handling methods, Breast Neoplasms pathology, Pathologists education, Pathology, Surgical trends, Specimen Handling standards
- Abstract
Competing Interests: None
- Published
- 2020
- Full Text
- View/download PDF
8. The coming 15 years in gynaecological pathology: digitisation, artificial intelligence, and new technologies.
- Author
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Farnell DA, Huntsman D, and Bashashati A
- Subjects
- Female, Humans, Artificial Intelligence trends, Genital Diseases, Female pathology, Pathology, Surgical trends, Precision Medicine trends
- Abstract
Surgical pathology forms the cornerstone of modern oncological medicine, owing to the wealth of clinically relevant information that can be obtained from tissue morphology. Although several ancillary testing modalities have been added to surgical pathology, the way in which we view and interpret tissue morphology has remained largely unchanged since the inception of our profession. In this review, we discuss new technological advances that promise to transform the way in which we access tissue morphology and how we use it to guide patient care., (© 2019 John Wiley & Sons Ltd.)
- Published
- 2020
- Full Text
- View/download PDF
9. Identity determination in diagnostic surgical pathology.
- Author
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Pfeifer JD
- Subjects
- High-Throughput Nucleotide Sequencing trends, Humans, Pathology, Surgical trends, High-Throughput Nucleotide Sequencing methods, Pathology, Surgical methods
- Abstract
From a technical perspective, specimen identity determination in surgical pathology over the last several decades has primarily focused on analysis of repetitive DNA sequences, specifically microsatellite repeats. However, a number of techniques have recently been developed that have similar, if not greater, utility in surgical pathology, most notably analysis of single nucleotide polymorphism (SNPs) and gene panels by next generation sequencing (NGS). For cases with an extremely limited sample or a degraded sample, sequence analysis of mitochondrial DNA continues to be the method of choice. From a diagnostic perspective, interest in identity determination in surgical pathology is usually centered on resolving issues of specimen provenance due to specimen labeling/accessioning deficiencies and possible contamination, but is also frequently performed in cases for which the patient's clinical course following definitive therapy is remarkably atypical, in cases of an unexpected diagnosis, and by patient request for "peace of mind". However, the methods used for identity determination have a much broader range of applications in surgical pathology beyond tissue provenance analysis. The methods can be used to provide ancillary information for cases in which the histomorphology is not definitively diagnostic, as for example for tumors that have a virtually identical microscopic appearance but for which the differential diagnosis includes synchronous/metachronous tumors versus a metastasis, and for the diagnosis of hydropic early gestations versus hydatidiform molar pregnancies. The methods also have utility in several other clinical settings, for example to rule out a donor-transmitted malignancy in a transplant recipient, to monitor bone marrow transplant engraftment, and to evaluate natural chimerism., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
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10. Ex Vivo Microscopy: A Promising Next-Generation Digital Microscopy Tool for Surgical Pathology Practice.
- Author
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Krishnamurthy S, Brown JQ, Iftimia N, Levenson RM, and Rajadhyaksha M
- Subjects
- Humans, Clinical Laboratory Techniques, Microscopy, Confocal, Microscopy, Fluorescence, Microscopy, Ultraviolet, Nonlinear Optical Microscopy, Pathology, Clinical methods, Tomography, Optical Coherence, Microscopy instrumentation, Microscopy methods, Microscopy trends, Optical Imaging instrumentation, Optical Imaging methods, Optical Imaging trends, Pathology, Surgical instrumentation, Pathology, Surgical methods, Pathology, Surgical trends
- Abstract
Context.—: The rapid evolution of optical imaging modalities in recent years has opened the opportunity for ex vivo tissue imaging, which has significant implications for surgical pathology practice. These modalities have promising potential to be used as next-generation digital microscopy tools for examination of fresh tissue, with or without labeling with contrast agents., Objective.—: To review the literature regarding various types of ex vivo optical imaging platforms that can generate digital images for tissue recognition with potential for utilization in anatomic pathology clinical practices., Data Sources.—: Literature relevant to ex vivo tissue imaging obtained from the PubMed database., Conclusions.—: Ex vivo imaging of tissues can be performed by using various types of optical imaging techniques. These next-generation digital microscopy tools have a promising potential for utilization in surgical pathology practice.
- Published
- 2019
- Full Text
- View/download PDF
11. Disease activity and mucosal healing in inflammatory bowel disease: a new role for histopathology?
- Author
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Pai RK and Geboes K
- Subjects
- Cytodiagnosis methods, Humans, Inflammatory Bowel Diseases pathology, Intestinal Mucosa pathology, Pathology, Surgical methods, Wound Healing, Cytodiagnosis trends, Histological Techniques trends, Inflammatory Bowel Diseases diagnosis, Pathology, Surgical trends
- Abstract
Histologic evaluation of disease activity in the setting of inflammatory bowel disease is gaining interest within the gastroenterology community. Recent data suggests that histologic measurements of inflammation in ulcerative colitis are more sensitive at detecting disease activity and perform better than endoscopic measurements in predicting clinical outcomes. Histologic measurements are also increasingly used in ulcerative colitis clinical trials to assess response to new therapies. Histologic measurements of disease activity are less well studied in Crohn's disease, but are gaining attention. Current published treatment algorithms in inflammatory bowel disease do not take into consideration histologic activity; however, this may change in the near future. In order for histologic measurements to be included in clinical decision-making, validated, reliable, and responsive histologic scoring systems are needed. In this review, the recent literature on the significance of histologic activity in both ulcerative colitis and Crohn's disease is summarized. Histologic scoring systems are also briefly discussed.
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- 2018
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- View/download PDF
12. Recent Developments in Surgical Pathology of the Uterine Corpus.
- Author
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Hanley KZ, Birdsong GG, and Mosunjac MB
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- Biomarkers, Tumor genetics, Biomarkers, Tumor metabolism, Endometrial Neoplasms genetics, Endometrial Neoplasms metabolism, Female, Humans, Immunohistochemistry, Mutation, Pathology, Surgical trends, Prognosis, Uterine Neoplasms genetics, Uterine Neoplasms metabolism, Uterus metabolism, Uterus pathology, Endometrial Neoplasms surgery, Pathology, Surgical methods, Uterine Neoplasms surgery, Uterus surgery
- Abstract
There have been several updates recently on the classification of uterine tumors. Endometrial carcinomas have traditionally been divided into 2 types, but some are difficult to classify and do not fit readily into either of the currently recognized categories. The Cancer Genome Atlas Research Network has recently defined 4 new categories of endometrial cancer on the basis of mutational spectra, copy number alteration, and microsatellite instability, which might provide independent prognostic information beyond established risk factors. The Society of Gynecologic Oncology, moreover, now recommends systematic screening of every patient with endometrial cancer for Lynch syndrome. The new definition of high-grade endometrial stromal sarcoma disregards the number of mitotic figures as a primary diagnostic criterion and instead specifies moderate atypia still resembling stromal origin but lacking the pleomorphism of undifferentiated uterine sarcoma; these tumors also harbor a JAZF1-SUZ12 gene rearrangement. Mitotic count, atypia, and coagulative necrosis are the main histologic criteria that define leiomyosarcoma. Determining the type of necrosis can be very challenging in patients receiving various treatment modalities for symptomatic fibroids before myomectomy, since key histologic features of ischemic-type necrosis are often absent. Ancillary stains including p16, p53, MIB-1, trichrome, and reticulin may be helpful in tumors harboring necrosis that is difficult to classify. Minimally invasive gynecologic surgeries have introduced histologic artifacts that complicate the diagnosis. It is essential to recognize these as procedure-related artifacts to avoid upstaging tumors and triggering unnecessary adjuvant treatment.
- Published
- 2017
- Full Text
- View/download PDF
13. Impacts of New Concepts and Technologies on the Practice of Diagnostic Pathology: An Emory University Perspective.
- Author
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Parslow TG, Adsay NV, Krasinskas AM, and Roback JD
- Subjects
- Biotechnology trends, Georgia, Humans, Neuropathology trends, Pathology, Surgical trends, Theranostic Nanomedicine trends, Universities, Pathology, Clinical trends
- Published
- 2017
- Full Text
- View/download PDF
14. Annual review issue: surgical pathology of 21st century medicine.
- Author
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Burt AD
- Subjects
- Humans, Pathology, Surgical trends
- Published
- 2017
- Full Text
- View/download PDF
15. Digital pathology in clinical use: where are we now and what is holding us back?
- Author
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Griffin J and Treanor D
- Subjects
- Humans, Pathology, Surgical trends, Telepathology trends, Image Interpretation, Computer-Assisted methods, Pathology, Surgical methods, Telepathology methods
- Abstract
Whole slide imaging is being used increasingly in research applications and in frozen section, consultation and external quality assurance practice. Digital pathology, when integrated with other digital tools such as barcoding, specimen tracking and digital dictation, can be integrated into the histopathology workflow, from specimen accession to report sign-out. These elements can bring about improvements in the safety, quality and efficiency of a histopathology department. The present paper reviews the evidence for these benefits. We then discuss the challenges of implementing a fully digital pathology workflow, including the regulatory environment, validation of whole slide imaging and the evidence for the design of a digital pathology workstation., (© 2016 John Wiley & Sons Ltd.)
- Published
- 2017
- Full Text
- View/download PDF
16. The changing landscape of gynaecological cancer diagnosis: implications for histopathological practice in the 21st century.
- Author
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Singh N and Gilks CB
- Subjects
- Female, Genital Neoplasms, Female genetics, Genital Neoplasms, Female pathology, Humans, Pathology, Surgical methods, Genital Neoplasms, Female diagnosis, Pathology, Surgical trends
- Abstract
The era of molecular medicine has led to dramatically improved understanding of the genetic events that give rise to different types of cancers. In the case of gynaecological malignancies, this has resulted in distinct shifts in how these tumours are diagnosed in routine surgical pathology practice, with an increased emphasis on accurate subtype diagnosis. This has happened across all sites in the gynaecological tract and for most cell types, but in ways that are site-specific and may appear to be subtle, as in most instances the diagnostic terminology has not changed. For example, the diagnosis of clear cell carcinoma of the ovary is still in use, but the diagnostic criteria and clinical implications are different in 2017 from what they were in 2000. As a result, there can be a failure to appreciate how important these changes are and the resulting necessity of incorporating them into our daily practice. In this review we will describe changes in diagnostic surgical pathology occasioned by improved understanding of molecular events during pathogenesis, for cancers of ovary/tube, endometrium, cervix and vulva, and highlight how current practice differs from that of only a few years ago., (© 2016 John Wiley & Sons Ltd.)
- Published
- 2017
- Full Text
- View/download PDF
17. Ex Vivo (Fluorescence) Confocal Microscopy in Surgical Pathology: State of the Art.
- Author
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Ragazzi M, Longo C, and Piana S
- Subjects
- Fluorescence, Microscopy, Confocal methods, Microscopy, Confocal trends, Pathology, Surgical methods, Pathology, Surgical trends
- Abstract
First developed in 1957, confocal microscopy is a powerful imaging tool that can be used to obtain near real-time reflected light images of untreated human tissue with nearly histologic resolution. Besides its research applications, in the last decades, confocal microscopy technology has been proposed as a useful device to improve clinical diagnosis, especially in ophthalmology, dermatology, and endomicroscopy settings, thanks to advances in instrument development. Compared with the wider use of the in vivo tissue assessment, ex vivo applications of confocal microscopy are not fully explored. A comprehensive review of the current literature was performed here, focusing on the reliable applications of ex vivo confocal microscopy in surgical pathology and on some potential evolutions of this new technique from pathologists' viewpoint.
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- 2016
- Full Text
- View/download PDF
18. The evolution of pre-analytic factors in Anatomic Pathology.
- Author
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Hewitt SM
- Subjects
- DNA chemistry, Formaldehyde chemistry, High-Throughput Screening Assays, Humans, Pathology, Molecular trends, RNA, Messenger chemistry, Pathology, Surgical trends, Specimen Handling methods, Specimen Handling standards, Specimen Handling trends, Tissue Fixation methods, Tissue Fixation standards, Tissue Fixation trends
- Abstract
Anatomic Pathology has continuously evolved since launch by Virchow in Berlin. The era from 1990 to 2010 saw the rise of immunohistochemistry and its application for diagnosis, prognosis, and prediction of response to therapy. Currently the next wave of evolution is ongoing; molecular pathology, with emphasis on alterations to DNA, and expression of mRNA as biomarkers. The interrogation of biomolecules by specific probes is more demanding on specimens than the traditional application of histologic stains to tissue. This issue is juxtaposed to the fact that the majority of specimens are purely evaluated by histomorphology, for which current specimen practices are adequate. The capacity to identify a priori which cassette of tissue is appropriate for molecular analysis is difficult, if not impossible, the goal is to improve the quality of all pathology specimens in an economically viable model to enable advanced assay, when applicable.
- Published
- 2015
- Full Text
- View/download PDF
19. Current projects in Pre-analytics: where to go?
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Sapino A, Annaratone L, and Marchiò C
- Subjects
- DNA chemistry, DNA genetics, Humans, Italy, Pathology, Molecular standards, Pathology, Surgical economics, Pathology, Surgical trends, RNA chemistry, RNA genetics, Specimen Handling methods, Specimen Handling standards, Investments, Neoplasms pathology, Pathology, Molecular economics, Specimen Handling economics
- Abstract
The current clinical practice of tissue handling and sample preparation is multifaceted and lacks strict standardisation: this scenario leads to significant variability in the quality of clinical samples. Poor tissue preservation has a detrimental effect thus leading to morphological artefacts, hampering the reproducibility of immunocytochemical and molecular diagnostic results (protein expression, DNA gene mutations, RNA gene expression) and affecting the research outcomes with irreproducible gene expression and post-transcriptional data. Altogether, this limits the opportunity to share and pool national databases into European common databases. At the European level, standardization of pre-analytical steps is just at the beginning and issues regarding bio-specimen collection and management are still debated. A joint (public-private) project entitled on standardization of tissue handling in pre-analytical procedures has been recently funded in Italy with the aim of proposing novel approaches to the neglected issue of pre-analytical procedures. In this chapter, we will show how investing in pre-analytics may impact both public health problems and practical innovation in solid tumour processing.
- Published
- 2015
- Full Text
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20. The modern pathologist: lab data deliverer, interpreter, and diagnostician.
- Author
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Brat DJ
- Subjects
- Eye Diseases surgery, Humans, Consultants, Diagnostic Techniques, Ophthalmological trends, Eye Diseases diagnosis, Neurology methods, Ophthalmology methods, Pathology, Surgical trends
- Published
- 2014
- Full Text
- View/download PDF
21. Increasing agreement over time in interlaboratory anatomic pathology consultation material.
- Author
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Renshaw AA and Gould EW
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- Humans, Retrospective Studies, Diagnostic Errors trends, Pathology, Surgical trends, Quality Assurance, Health Care, Referral and Consultation trends
- Abstract
Objectives: To undertake a retrospective study of the rate of diagnostic discrepancy for patient/clinician-initiated second opinions in anatomic pathology at our institution and determine if this rate has changed and whether the change could be explained., Methods: We reviewed all patient/clinician-initiated consults (incoming and outgoing) handled by our institution over a 6¾-year (27 quarters) period in which the original and consult reports were available., Results: The rate of disagreement from the first 14 to the second 13 quarters declined from 20.4% to 15.4% (P = .004) for incoming consults and from 9.7% to 4.1% (P < .001) for outgoing consults. Significant decreases in the rate of immunohistochemistry, percentage of reports with 2 pathologists' names, and percentage of cytology and endocrine cases were noted for incoming consults. Only a decrease in the percentage of cases with 2 pathologists' names was identified in outgoing consultations., Conclusions: Disagreements in interlaboratory anatomic pathology consults decreased over time, and some but not all changes had features associated with increased agreement.
- Published
- 2013
- Full Text
- View/download PDF
22. Five top stories in anatomic pathology: stories from the faculty at UMass Medical School and UMass Memorial Medical Center, Worcester, Massachusetts.
- Author
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Fraire AE
- Subjects
- Massachusetts, Pathology, Surgical trends, Faculty, Medical, Pathology, Surgical methods, Schools, Medical
- Published
- 2013
- Full Text
- View/download PDF
23. Annual review issue: gynaecological pathology.
- Author
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McCluggage WG and Soslow RA
- Subjects
- Female, Gynecology trends, Humans, Pathology, Surgical trends, Precision Medicine, Genital Neoplasms, Female pathology, Gynecology methods, Pathology, Surgical methods
- Published
- 2013
- Full Text
- View/download PDF
24. Precision medicine for lung cancer: role of the surgical pathologist.
- Author
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Cagle PT and Myers J
- Subjects
- Biomarkers, Tumor, Humans, Lung Neoplasms diagnosis, Lung Neoplasms genetics, Lung Neoplasms surgery, Pathology, Surgical trends
- Abstract
Precision medicine is altering the traditional role of the surgical pathologist in caring for patients with lung cancer. Diagnosing specific cell type is now a foundation for selecting lung cancers for predictive-biomarker testing by molecular techniques. Using conventional techniques and familiar equipment, the surgical pathologist's role goes beyond this important step and will include screening for, and possibly diagnosis of, predictive biomarkers as we illustrate for one predictive biomarker. Pathologists should embrace the innovations described at the Houston Lung Symposium but must recognize that their traditional expertise will be an important component of precision medicine for the foreseeable future.
- Published
- 2012
- Full Text
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25. Future Path: frontiers of molecular and cellular pathology.
- Author
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Rasko JE
- Subjects
- Cytodiagnosis, Humans, Pathology, Clinical trends, Pathology, Molecular trends, Pathology, Surgical trends
- Published
- 2011
- Full Text
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26. Prostate cancer staging and grading at radical prostatectomy over time.
- Author
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Falzarano SM and Magi-Galluzzi C
- Subjects
- Adenocarcinoma blood, Adenocarcinoma surgery, Humans, Male, Neoplasm Staging, Pathology, Surgical trends, Prognosis, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Prostatic Neoplasms surgery, Adenocarcinoma pathology, Prostatectomy methods, Prostatic Neoplasms pathology
- Abstract
Prostate-specific antigen (PSA) testing has been associated with a sharp increase in prostate cancer (PCA) detection after its introduction in the late 1980s. Since its launch and its implementation as diagnostic test in 1994, temporal patterns in patients' age and serum PSA level at presentation have changed, with younger patients being diagnosed at lower PSA cutoff levels. Many studies suggest that PSA screening has resulted in a profound downward migration in clinical and pathologic stage of newly diagnosed PCA, although the effect has slowed in the most recent years. The impact on tumor grading is less clear. Histologic grading of PCA, based on the Gleason system, is predictive of the biological behavior and prognosis of the tumor. If tumor progresses from low grade to high grade, the early detection would lead to a higher percentage of low-grade disease diagnosed over time. However, published data suggest that tumor grade shifts have occurred over time and are unlikely to be attributable to changes in tumor biology, but rather to changes in practice with respect to Gleason grading. This review will address PCA staging and grading trends from the pre-PSA era to the present time with emphasis on the potential role played by changes in clinical and pathologic practice.
- Published
- 2011
- Full Text
- View/download PDF
27. Recent trends in quality, patient safety, and error reduction in nongyn cytology.
- Author
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Silverman JF
- Subjects
- Adult, Aged, 80 and over, Biopsy, Fine-Needle, Diagnostic Errors trends, Female, Humans, Male, Neoplasms pathology, Quality Assurance, Health Care methods, Quality Assurance, Health Care standards, Quality Assurance, Health Care trends, Quality Control, Referral and Consultation statistics & numerical data, Cytological Techniques standards, Diagnostic Errors prevention & control, Pathology, Surgical methods, Pathology, Surgical standards, Pathology, Surgical trends
- Abstract
This article reviews recent trends in nongyn cytology with an emphasis on error reduction, second opinion, and critical diagnosis. Compared with the surgical pathology literature, there is only a limited number of reports addressing these topics in nongyn cytology. Discussion of the error literature in nongyn cytology is presented with the intent to better identify error-prone cytology cases that could prompt intradepartmental consultation or an outside cytology expert's second opinion. The cytology second-opinion literature is also reviewed with the recommendation that interinstitutional second opinions add value to patient care. Last, the recent concept of critical value (critical diagnosis) in cytopathology is presented. All these initiatives promote patient safety, improve quality, decrease errors, and benefit patients.
- Published
- 2010
- Full Text
- View/download PDF
28. Digital microscopy: past, present, and future.
- Author
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Hedvat CV
- Subjects
- Laboratories trends, Microscopy methods, Pathology, Surgical methods, Image Processing, Computer-Assisted trends, Microscopy trends, Pathology, Surgical trends
- Abstract
Context: Digital viewing of histologic images is moving from presentations and publications to incorporation into the daily work of practicing pathologists. Many technologic limitations have been overcome recently, which should make widespread adoption more practical. The task now is for pathologists to become actively involved in its development and implementation, to ensure that the technology is developed with the intent to optimize workflow and to maintain diagnostic accuracy. An understanding of the basic precepts of digital imaging is required to make informed decisions related to hardware and software implementation and to collaborate with vendors and professionals outside of pathology (eg, regulatory agencies) as the technology rapidly develops., Objective: To describe the state of digital microscopy as it applies to the field of pathology and to define specific issues related to adoption of whole slide imaging systems., Data Sources: The information is derived from the experience of the author and review of the literature., Conclusions: Digital microscopy is an important tool for surgical pathologists. It is currently an area of intense and rapid technologic development that will likely transform the workflow of many laboratories during the next several years.
- Published
- 2010
- Full Text
- View/download PDF
29. Increasing radiation from sentinel node specimens in pathology over time.
- Author
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Renshaw AA, Kish R, and Gould EW
- Subjects
- Humans, Radiometry, Pathology, Surgical trends, Radioactive Tracers, Sentinel Lymph Node Biopsy methods
- Abstract
Previous studies have recommended no special precautions for radiation when handling sentinel node specimens in the pathology laboratory. We reviewed 7 years of data concerning radioactivity in 2,902 sentinel node and primary resection specimens received in our pathology laboratory. The percentage of specimens with greater than background radiation (> or =0.2 mrem/h) rose from 6.3% to 34.8% from 2003 to 2009 (P < .001); specimens with more than 10 mrem/h rose from 0.0% to 9.3% (P < .001). Four specimens were measured at 100 mrem/h. While mastectomy followed by skin excisions for melanoma were the most common specimens to have radiation more than 2.0 mrem/h (32.2% and 27.3%, respectively), this level of radiation was found in all types of cases examined. The radiation dose administered to individual patients for specimens with more than 30 mrem/h was significantly higher than a sample of specimens with less than 0.2 mrem/h (n = 25 each; median, 1.3 and 1.0 mCi, respectively; P = .02). While the higher level of radiation we found correlates with increasing administered dose of radiation, other factors may also have a role. Routine measurement of radioactivity for all sentinel node specimens in the pathology laboratory is recommended.
- Published
- 2010
- Full Text
- View/download PDF
30. [What is new in 2010 for electron microscopy in surgical pathology?].
- Author
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Mari M, Hofman V, Butori C, Ilie M, Lassalle S, Grier P, Sadoulet D, Scoazec JY, and Hofman P
- Subjects
- Diagnosis, Differential, Humans, Infections pathology, Infections surgery, Neoplasms surgery, Pathology, Surgical trends, Microscopy, Electron methods, Neoplasms pathology, Pathology, Surgical methods
- Abstract
In the last decades, several ancillary methods, such as immunohistochemistry and molecular biology techniques, have increased the possibilities for the diagnosis and to evaluate the prognosis of lesions observed in a laboratory of pathology. Conversely, the impact of another method largely used a couple of years ago in a laboratory of pathology, the electron microscopy (EM), is currently limited. EM is a difficult, quite expensive and long method, which requires technicians with a high qualification. Therefore, EM is currently rarely available at the hospital in a laboratory of pathology and is essentially established in research centers. However, EM is still an essential tool for the surgical pathologist. This method allows in some circumstances to confirm or, more rarely, to make the diagnosis of a couple of tissular and cellular lesions observed in human pathology. EM is also an interesting method to better understand the etiopathogenesis of emerging human diseases, in particular of emerging infectious diseases. In this review, we report the main indication of EM in human pathology, we lay special emphasize in certain infectious diseases and neoplasia., (Copyright 2010 Elsevier Masson SAS. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
31. Molecular pathology in contemporary diagnostic pathology laboratory: an opinion for the active role of surgical pathologists.
- Author
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Lauwers GY, Black-Schaffer S, and Salto-Tellez M
- Subjects
- History, 20th Century, History, 21st Century, Humans, Pathology, Molecular history, Pathology, Surgical history, Pathology, Molecular trends, Pathology, Surgical trends
- Published
- 2010
- Full Text
- View/download PDF
32. Short history of the autopsy: part II. From the second half of the 16th century to contemporary times.
- Author
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Gulczyński J, Iżycka-Świeszewska E, and Grzybiak M
- Subjects
- Dissection history, Europe, History, 16th Century, History, 17th Century, History, 18th Century, History, 19th Century, History, 20th Century, History, 21st Century, Humans, Paintings history, Pathology, Surgical trends, Autopsy history, Pathology, Surgical history
- Abstract
We present the second part of our review concerning the history of autopsy. During the development of medicine the role of autopsy was obviously changing. Concurrently with the progress in the anatomical knowledge, the anatomists observed and noted both single anomalies and repetitive changes which correlated with symptoms in living patients. This is how anatomopathology came into being. We present the most famous people engaged in autopsy comprehension. We discuss main trends and ideas influencing the phenomenon of autopsy in the analyzed period: from sporadic public dissections, through theatra anatomica, introduction of autopsy to the hospital medicine and separation of anatomopathology as a medical speciality. The golden age of autopsy was the 19th century and the first half of the 20th century, with a consecutive decline in frequency. Nevertheless, despite the progress in diagnostics in vivo, it seems that autopsy will keep its important place in medicine according to the old motto "Mortui vivos docent" (the dead teach the living).
- Published
- 2010
33. Digital pathology: exploring its applications in diagnostic surgical pathology practice.
- Author
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Jara-Lazaro AR, Thamboo TP, Teh M, and Tan PH
- Subjects
- Frozen Sections instrumentation, Frozen Sections methods, Frozen Sections trends, Humans, Image Processing, Computer-Assisted instrumentation, Image Processing, Computer-Assisted trends, Microscopy instrumentation, Microscopy trends, Pathology, Surgical instrumentation, Pathology, Surgical trends, Remote Consultation instrumentation, Remote Consultation methods, Remote Consultation trends, Telepathology instrumentation, Telepathology trends, Image Processing, Computer-Assisted methods, Microscopy methods, Pathology, Surgical methods, Telepathology methods
- Abstract
There has been a recent upsurge in worldwide attention on digital pathology, which has transformed from static snapshots from camera-equipped microscopes to its modern form that encompasses scanning of whole glass slides with evaluation of histological images on a computer screen, along with management of its accompanying information. Although it has been widely accepted in education and research, its implementation in diagnostic surgical pathology practice is not without challenges in workflow integration, technological infrastructure, pathologist acclimatisation, global standardisation for clinical practice, and cost issues, among others. Nonetheless, early adopters have harnessed its benefits in specific niches, like frozen section services and remote second opinion consultations. Its tremendous potential is worthy of further validation to compare with conventional glass slide evaluation, even while it is already paving the way for advancement into virtual three-dimensional imaging technology, with a glimpse into a possible future digital diagnostic pathology practice.
- Published
- 2010
- Full Text
- View/download PDF
34. New frontiers in pathology.
- Author
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Visscher DW and Myers JL
- Subjects
- Humans, Pathology, Clinical trends, Pathology, Surgical trends, User-Computer Interface, Education, Medical, Continuing, Pathology, Clinical education, Pathology, Surgical education
- Published
- 2009
- Full Text
- View/download PDF
35. Virtual microscopy in pathology education.
- Author
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Dee FR
- Subjects
- Humans, Image Processing, Computer-Assisted instrumentation, Microscopy instrumentation, Microscopy trends, Pathology, Surgical instrumentation, Pathology, Surgical methods, Pathology, Surgical trends, Telepathology, Education, Medical trends, Image Processing, Computer-Assisted methods, Microscopy methods, Pathology education
- Abstract
Technology for acquisition of virtual slides was developed in 1985; however, it was not until the late 1990s that desktop computers had enough processing speed to commercialize virtual microscopy and apply the technology to education. By 2000, the progressive decrease in use of traditional microscopy in medical student education had set the stage for the entry of virtual microscopy into medical schools. Since that time, it has been successfully implemented into many pathology courses in the United States and around the world, with surveys indicating that about 50% of pathology courses already have or expect to implement virtual microscopy. Over the last decade, in addition to an increasing ability to emulate traditional microscopy, virtual microscopy has allowed educators to take advantage of the accessibility, efficiency, and pedagogic versatility of the computer and the Internet. The cost of virtual microscopy in education is now quite reasonable after taking into account replacement cost for microscopes, maintenance of glass slides, and the fact that 1-dimensional microscope space can be converted to multiuse computer laboratories or research. Although the current technology for implementation of virtual microscopy in histopathology education is very good, it could be further improved upon by better low-power screen resolution and depth of field. Nevertheless, virtual microscopy is beginning to play an increasing role in continuing education, house staff education, and evaluation of competency in histopathology. As Z-axis viewing (focusing) becomes more efficient, virtual microscopy will also become integrated into education in cytology, hematology, microbiology, and urinalysis.
- Published
- 2009
- Full Text
- View/download PDF
36. Primary frozen section diagnosis by robotic microscopy and virtual slide telepathology: the University Health Network experience.
- Author
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Evans AJ, Chetty R, Clarke BA, Croul S, Ghazarian DM, Kiehl TR, Perez Ordonez B, Ilaalagan S, and Asa SL
- Subjects
- Diagnostic Errors statistics & numerical data, Humans, Pathology, Surgical trends, Reproducibility of Results, Robotics methods, Frozen Sections methods, Hospitals, University, Microscopy methods, Pathology, Surgical methods, Robotics instrumentation, Telepathology methods
- Abstract
Although telepathology (TP) has not been widely implemented for primary frozen section diagnoses, interest in its use is growing as we move into an age of increasing subspecialization and centralization of pathology services. University Health Network is a 3-site academic institution in downtown Toronto. The pathology department is consolidated at its Toronto General Hospital (TGH) site. The Toronto Western Hospital (TWH), located 1 mile to west of TGH, has no on-site pathologist, and generates 5 to 10 frozen section cases per week. More than 95% of these frozen sections are submitted by neurosurgeons, in most cases to confirm the presence of lesional tissue and establish a tissue diagnosis. In 2004, we implemented a robotic microscopy (RM) TP system to cover these frozen sections. In 2006, we changed to a virtual slide (VS) TP system. Between November 2004 and September 2006, 350 primary frozen section diagnoses were made by RM. An additional 633 have been reported by VS TP since October 2006, giving a total of 983 frozen sections from 790 patients. Of these cases, 88% have been single specimens with total turnaround times averaging 19.98 and 15.68 minutes per case by RM and VS TP, respectively (P < .0001). Pathologists required an average of 9.65 minutes to review a slide by RM. This decreased 4-fold to 2.25 minutes after the change to VS TP (P < .00001). Diagnostic accuracy has been 98% with both modalities, and our overall deferral rate has been 7.7%. Midcase technical failure has occurred in 3 cases (0.3%) resulting in a delay, where a pathologist went to TWH to report the frozen section. Discrepant cases have typically involved minor interpretive errors related to tumor type. None of our discrepant TP diagnoses has had clinical impact to date. We have found TP to be reliable and accurate for frozen section diagnoses. In addition to its superior speed and image quality, the VS approach readily facilitates consultation with colleagues on difficult cases. As a result, there has been greater overall pathologist satisfaction with VS TP.
- Published
- 2009
- Full Text
- View/download PDF
37. Overview of telepathology, virtual microscopy, and whole slide imaging: prospects for the future.
- Author
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Weinstein RS, Graham AR, Richter LC, Barker GP, Krupinski EA, Lopez AM, Erps KA, Bhattacharyya AK, Yagi Y, and Gilbertson JR
- Subjects
- Humans, Microscopy methods, Pathology, Surgical education, Pathology, Surgical methods, Telepathology methods, Telepathology organization & administration, User-Computer Interface, Computer Communication Networks, Image Processing, Computer-Assisted, Microscopy trends, Pathology, Surgical trends, Telepathology trends
- Abstract
Telepathology, the practice of pathology at a long distance, has advanced continuously since 1986. Today, fourth-generation telepathology systems, so-called virtual slide telepathology systems, are being used for education applications. Both conventional and innovative surgical pathology diagnostic services are being designed and implemented as well. The technology has been commercialized by more than 30 companies in Asia, the United States, and Europe. Early adopters of telepathology have been laboratories with special challenges in providing anatomic pathology services, ranging from the need to provide anatomic pathology services at great distances to the use of the technology to increase efficiency of services between hospitals less than a mile apart. As to what often happens in medicine, early adopters of new technologies are professionals who create model programs that are successful and then stimulate the creation of infrastructure (ie, reimbursement, telecommunications, information technologies, and so on) that forms the platforms for entry of later, mainstream, adopters. The trend at medical schools, in the United States, is to go entirely digital for their pathology courses, discarding their student light microscopes, and building virtual slide laboratories. This may create a generation of pathology trainees who prefer digital pathology imaging over the traditional hands-on light microscopy. The creation of standards for virtual slide telepathology is early in its development but accelerating. The field of telepathology has now reached a tipping point at which major corporations now investing in the technology will insist that standards be created for pathology digital imaging as a value added business proposition. A key to success in teleradiology, already a growth industry, has been the implementation of standards for digital radiology imaging. Telepathology is already the enabling technology for new, innovative laboratory services. Examples include STAT QA surgical pathology second opinions at a distance and a telehealth-enabled rapid breast care service. The innovative bundling of telemammography, telepathology, and teleoncology services may represent a new paradigm in breast care that helps address the serious issue of fragmentation of breast cancer care in the United States and elsewhere. Legal and regulatory issues in telepathology are being addressed and are regarded as a potential catalyst for the next wave of telepathology advances, applications, and implementations.
- Published
- 2009
- Full Text
- View/download PDF
38. Recent developments in the pathology of renal tumors: morphology and molecular characteristics of select entities.
- Author
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Yan BC, Mackinnon AC, and Al-Ahmadie HA
- Subjects
- Biomarkers, Tumor genetics, Carcinoma, Renal Cell diagnosis, Carcinoma, Renal Cell genetics, Chromosomes, Human, X genetics, Diagnosis, Differential, Humans, Kidney Neoplasms diagnosis, Kidney Neoplasms genetics, Translocation, Genetic genetics, Carcinoma, Renal Cell pathology, Kidney Neoplasms pathology, Pathology, Surgical trends
- Abstract
Context: Renal cell carcinoma is a heterogeneous group of tumors with distinct histopathologic features, molecular characteristics, and clinical outcome. These tumors can be sporadic as well as familial or associated with syndromes. The genetic abnormalities underlying these syndromes have been identified and were subsequently found in corresponding sporadic renal tumors., Objective: To review the recent molecular and genetic advancements relating to sporadic and familial renal carcinomas as well as those related to Xp11.2 translocation-associated renal cell carcinoma and renal medullary carcinoma., Data Sources: Literature review, personal experience, and material from the University of Chicago., Conclusions: Molecular genetic diagnostic techniques will continue to introduce new biomarkers that will aid in the differential diagnosis of difficult cases. The identification of specific signaling pathways that are defective in certain renal tumors also makes possible the development of new therapies that selectively target the aberrant activity of the defective proteins.
- Published
- 2009
- Full Text
- View/download PDF
39. Update in surgical pathology.
- Author
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Husain AN
- Subjects
- Biomarkers, Tumor metabolism, Central Nervous System Neoplasms diagnosis, Central Nervous System Neoplasms metabolism, Humans, Kidney Neoplasms classification, Kidney Neoplasms therapy, Lymphoma, Large B-Cell, Diffuse classification, Lymphoma, Large B-Cell, Diffuse pathology, Skin Diseases diagnosis, Skin Diseases pathology, Pathology, Surgical trends
- Published
- 2009
- Full Text
- View/download PDF
40. [Surgical pathology in the era of molecular medicine].
- Author
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Zhu XZ
- Subjects
- Humans, Molecular Diagnostic Techniques, Pathology, Molecular methods, Pathology, Surgical methods, Translational Research, Biomedical, Neoplasms pathology, Pathology, Molecular trends, Pathology, Surgical trends
- Published
- 2009
41. Is clinical systems pathology the future of pathology?
- Author
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Costa J
- Subjects
- Delivery of Health Care, Integrated, Humans, Medical Laboratory Science methods, Pathology, Surgical methods, Patient Care Team, Hospital Information Systems trends, Medical Laboratory Science trends, Pathology, Surgical trends
- Published
- 2008
- Full Text
- View/download PDF
42. A survey of the myriad forces changing anatomic pathology and their consequences.
- Author
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Friedman BA
- Subjects
- Biomarkers, Diagnosis, Computer-Assisted, Early Diagnosis, Health Care Costs, Humans, Molecular Diagnostic Techniques, Patient Care Team, Clinical Laboratory Techniques methods, Clinical Laboratory Techniques trends, Pathology, Surgical methods, Pathology, Surgical trends
- Published
- 2008
- Full Text
- View/download PDF
43. Beyond morphology: whole slide imaging, computer-aided detection, and other techniques.
- Author
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Feldman MD
- Subjects
- Biomarkers, Tumor analysis, Female, Flow Cytometry, Humans, Immunohistochemistry, Microscopy, Fluorescence, Nanotechnology, Pathology, Surgical trends, Spectrum Analysis, Staining and Labeling, Image Processing, Computer-Assisted, Pathology, Surgical methods
- Published
- 2008
- Full Text
- View/download PDF
44. Putting the "more" back in morphology: spectral imaging and image analysis in the service of pathology.
- Author
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Levenson R
- Subjects
- Female, History, 18th Century, History, 19th Century, History, 20th Century, History, 21st Century, Humans, Male, Pathology, Surgical trends, Spectrum Analysis, Image Processing, Computer-Assisted, Microscopy history, Pathology, Surgical methods
- Published
- 2008
- Full Text
- View/download PDF
45. Practical applications of telepathology using morphology-based anatomic pathology.
- Author
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O'Malley DP
- Subjects
- Health Care Costs, Humans, Remote Consultation, Pathology, Surgical trends, Telepathology
- Published
- 2008
- Full Text
- View/download PDF
46. The S-curve framework: predicting the future of anatomic pathology.
- Author
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Weinstein RS
- Subjects
- Humans, Diffusion of Innovation, Pathology, Surgical trends, Telepathology
- Published
- 2008
- Full Text
- View/download PDF
47. Time for a reality check: the hospital-based laboratory's perspective.
- Author
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Friedberg RC
- Subjects
- Commerce, Forecasting, Humans, Personnel, Hospital, Radiology, Laboratories, Hospital economics, Laboratories, Hospital standards, Laboratories, Hospital trends, Pathology, Surgical trends
- Published
- 2008
- Full Text
- View/download PDF
48. Use of digital video for documentation of microscopic features of tissue samples.
- Author
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Melín-Aldana H, Gasilionis V, and Kapur U
- Subjects
- Humans, Pathology, Surgical trends, Technology methods, Technology trends, Documentation methods, Image Processing, Computer-Assisted, Pathology, Surgical methods, Video Recording
- Abstract
Context: Digital photography is commonly used to document microscopic features of tissue samples, but it relies on the capture of arbitrarily selected representative areas. Current technologic advances permit the review of an entire sample, some even replicating the use of a microscope., Objective: To demonstrate the applicability of digital video to the documentation of histologic samples., Design: A Canon Elura MC40 digital camcorder was mounted on a microscope, glass slide-mounted tissue sections were filmed, and the unedited movies were transferred to a Apple Mac Pro computer. Movies were edited using the software iMovie HD, including placement of a time counter and a voice recording., Results: The finished movies can be viewed in computers, incorporated onto DVDs, or placed on a Web site after compression with Flash software. The final movies range, on average, between 2 and 8 minutes, depending on the size of the sample, and between 50 MB and 1.6 GB, depending on the intended means of distribution, with DVDs providing the best image quality., Conclusions: Digital video is a practical methodology for documentation of entire tissue samples. We propose an affordable method that uses easily available hardware and software and does not require significant computer knowledge. Pathology education can be enhanced by the implementation of digital video technology.
- Published
- 2008
- Full Text
- View/download PDF
49. Pathology RE-imagined: the history of digital radiology and the future of anatomic pathology.
- Author
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Montalto MC
- Subjects
- History, 20th Century, History, 21st Century, Hospital Information Systems, Humans, Information Management, Interdisciplinary Communication, Pathology, Surgical trends, Telepathology, Teleradiology history
- Published
- 2008
- Full Text
- View/download PDF
50. IBM's vision for the future in patient-centric global health care: IBM's vision of how advanced health analytics and automated health information infrastructure will transform anatomic pathology services.
- Author
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Bakalar R
- Subjects
- Entrepreneurship, Humans, Delivery of Health Care trends, Global Health, Information Services trends, Pathology, Surgical trends, Patient-Centered Care trends
- Published
- 2008
- Full Text
- View/download PDF
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