Introduction dentistry.ppt

Introduction

• Pathology - a branch of medicine studying diseases

• outer and inner factors causing diseases - etiology(TB - caused by Mycobacterium tuberculosis)

Introduction

• how and why - development - pathogenesis(infectious endocarditis - thrombembolism -

multiple abscesses)

• related disciplines: anatomy, histology, microbiology, clinical chemistry, hematology, laboratory medicine

• autopsy

• search for changes in dead patients, correlation with clinical symptoms - feed-back

• educational role

• chronic toxicity studies (pharmaceutic industry)

• pathological autopsy is different from anatomic autopsy and forensic autopsy

• gross examination, microscopy, special methods (cultivation, chemical tests, etc.)

Methods used in pathology

• biopsy (surgical pathology)

• 80% of workload

• since 1950!

• microscopical diagnostics, for living patients

• histology, cytology (exfoliative-Pap test; fluids, fine needle aspiration cytology)

Methods used in pathology

• specimens:

• fluids (physiological - urine; pathological - pus, ascites)

• endoscopic samples (gastroscopy, colonoscopy, bronchoscopy, etc.)

• tru-cut needle biopsy (liver, kidney, prostate)

• diagnostic excisions (skin, breast, pancreas)

• entire organs (hysterectomy, mastectomy, lung resection, colectomy)

• pathological dx = golden standard (important for treatment) (A. Hailey: Final diagnosis)

Methods used in pathology

How to handle specimen for

histology• fixation (×frozen section)

• clinical information (identification!!!!; symptoms; preliminary diagnosis; what do you expect from pathologist)

History of pathology• Vesalius

• 1475 - Sixtus IV. - permits to use cadavers in teaching of medical students

• 1485 - Clement VII. - the same

• 18th cent. - Jean Baptist Morgagni (1682-1772) - 700 autopsies - case reports - clinico-morphologic correlations - founder of modern

pathology

• 19th cent. - Karl Rokitanski (Austria) - born 1804 in Hradec Králové, University of Vienna, 50 000 of autopsies - only gross examination

• Rudolf Virchow - founder of modern pathology (classification of tumors, mitosis, apoptosis, causal relationships) - Berlin (Charité)

• our country:

• Jesenius 1600, 1605 - two public autopsies

• Prof. Jaroslav Hlava - end of 198th cent. - his last pupil was Dr. Antonin Fingerland (1900-1999)

• 1928 - Dept. of Pathology in Hradec Králové - inspiration = Mayo Clinic (clinicopathologic conferences, close cooperation,

continuous education)

History of pathology

Organization of education

• general pathology - main principles

• systemic pathology - diseases and pathologic processes in different organ systems

• lectures - www.lfhk.cuni.cz/patanat (Aleš Ryška, MD, PhD; Karel Dědič, MD, PhD)

• practical classes - Karel Dědič, MD, PhD (excursion at the Department, autopsy, surgical pathology, microscopy)

• textbooks:

• Basic Pathology (Cumar, Cotran, Robbins)

• Oral Pathology (van der Waal, van der Kwast)

• you MUST know before start of your practical classes: normal anatomy, normal histology of most important organs, basic embryology, normal physiology)

Organization of education

• pay close attention to other disciplines!!! (pathophysiology, microbiology, biology, biochemistry)

• credits - examination of histologic slides

• exam - lectures, practicals, Robbins, van der Waal

• 49 583 3748 Dr. Ryška

• 49 583 2287 Dr. Dědič

• 49 583 2611 Mrs. Hejnová (secretary)

Organization of education

Good luck !