Pathology Introduction

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PathologyIntroduction

• Su Min
• Department of pathology
• Shantou University Medical College

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Why should we study pathology? Students often
ask me this question in the class

• I also have a question to ask you
• Why did you
  come here?
• The your goal is very clearly
• want to be Medical Doctor!

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Severe Acute Respiratory Syndrome (SARS) make a
surprise attack on people anybody could stand
aside except medical staffers
Quoted from 21cn.com
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• Cure Severe Acute Respiratory Syndrome (SARS)
  patient (extracted from 21cn.com) Angell
  heal the wounded and rescue the dying

Quoted from 21cn.com
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Question

• Patients just want to know
• What disease am I suffering from?
• How to cure it?

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The key point of medical science

• To prevent
• To diagnose Disease
• To treat
• ( Control)

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What is Pathology (Pathologia)

• Prefix
• Path(pathos) means suffering, disease
• Postfix
• Ology(logos) means study, science

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The concept of pathology

• Pathology is the scientific study of disease.

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• The contents of pathology
• the causes (aetiology )
• mechanisms (Pahogenesis)
• pathologic changes structural funcional
• 
  abnormalities
• the descriptions of the manifestations
• its progress and sequels.

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1. Causes of disease

• 1). Genetic factors
• Abnormal the chromosomes and component genes
• Occur spontaneously (or without known
  cause)
• In some cases, radiations, chemical or
  infective agents can be incriminated.
• (2) Susceptibility to some diseases
• Genetic polymorphisms among or between
  individuals, families, or races strongly
  influence susceptibility and resistance to disease

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Quoted from Dr. T.M. Schroeder-Kurth
congenital mentally retarded children
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Quoted from Dr. Vogel. Motulsky Human Genetics
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• 2). Environmental factors
• (1) Physical agents. i. e. injury, radiations,
  extremes of heat or cold, electrical power
• (2) Chemical poisons. Some act in a general
  manner, some act locally, and some exhibit a
  predilection for certain organs.
• (3) Nutritional imbalance
• (4) Abnormal immunological reactions.
• (5) Psychological factors

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• Although the causes of disease are
• divided into above two main groups,
• but both groups are interlaced in most disease.

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2. Pathogenesis

• Means Mechanisms
• Most are still investigating.
• Some of them should be known,
• for instance
• Thrombosis
• Myocardial infarction

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3. Pathologic changes

• Level A. Naked eye level
• gross changes in diseased
  organs.
• Level B. Light microscopic level
• in histological and cytological
  level.
• Level C. Electron-microscopic(EM) level
• in the ultrastructure (cellular
  organelles).
• Level D. Molecular level
• inspect aberrant in DNA, RNA, and
  protein.

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4. Manifestations

• Clinical significance
• The functional consequences of the morphologic
  changes.

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5. Progress and sequels

• Progress
• simple intricate
• short-term long-term
• Sequels
• healing
• un-healing delay complications
• spread even death

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Investigation of disease

• In medical practice the objective of the study
  of disease is twofold.
• To determine the nature of the disease for
  establishing a diagnosis.
• To control the extent and progress of the disease
  for treating.

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The classification of pathology

• General pathology A discussion of disease
  fundamentals oriented horizontally (nature of
  process).
• injury, repair, inflammation, neoplasia.
• Systemic pathology A more detailed discussion of
  diseases oriented vertically. i. e.
  cardiovascular diseases, respiratory diseases,
  alimentary diseases, endocrine diseases, renal
  diseases, infectious diseases.
• e.g. What is the commonest disease in the clinic
• trachoma, common cold, gastritis,
  hepatitis,athlete's foot

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The location and importance of pathology in
medical education

• Pathology is a bridge between basic science and
  clinical medicine. All of the medical students
  have to stride over the bridge!

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Methods in pathology

• Autopsy An examination of a dead body was done
  by cutting it open to discover the cause of
  death.

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• Biopsy

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Quoted from CIBA COLLECTION MEDICAL
ILLUSTRATIONS
An examination of pathologic samples from living
body to set up diagnosis
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• Cellular examination

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• Animal experimentation

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Se-deficiency animal model National Natural
Science Foundation of China (No. 30170832 ) Su
Min, Zhang Rui-Juan et al.
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• Tissue and cell culture

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One Newly Established esophageal carcinoma(EC)
Cell Line CSEC-215 from EC patient in Chaoshan
Region of China. Lu Shan-Ming, Su Min et al.
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Neural stem cell National Natural Science
Foundation of China (No. 30170832 ) Tian
Dong-Ping, Su Min et al.
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• Immunohistochemistry and immuno-cytochemistry

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Esophageal carcinoma E-cad in membrane Wu
Ming-Yao et al.
GFAP in cytoplasm of neuroglia cell. Tian
Dong-Ping, Su Min et al.
Fos in nucleus
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• Electron microscopic examination

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Atypia of tumor cells(Pleomorphism of nuclei) in
CSEC-215 generation 13 EM3000
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• Confocal laser scanning microscopic examination

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Confocal laser scanning microscopy
neuron
three-dimensional
nuclear division
DNA content
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• In situ hybridization

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• Chromosome analysis
• Gene clone

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• Biochip

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History and development of pathology

• Humoral Pathology
• Hippocrates (460-377 BC)

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History and development of pathology

• Organ Pathology
• Morgagni
• (Italian,1682-1771 DC)

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History and development of pathology

• CellularPathology
• Virchow
• (German, 1882-1902 DC)

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??? ?? (1899-1968)
??? ?? (1896-1968)
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• Modern Pathology (1920S-)
• Ultrastructural Pathology
• Molecular Pathology
• Immunopathology
• Genetic Pathology

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How to study pathology Summary

• Students should pay a more attention to
  following six aspects
• Concepts to master lots of concept is basic
  processes of studying pathology.
• Cause(why) Location (where) Change(what)

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• Diseases Pathology Clinical
  Practice

Diagnosing disease   Treating disease   Preventing
disease
(1) Causes (aetiology) (2) Mechanisms
(Pathogenesis) (3) Pathological changes (4)
Manifestations (5) Progress and sequels
Variations of structure function outside normal
range
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MAIN REFERENCE

• 1.    Alasdair D. T. Govan, Peter S.
  Macfarlane, Robin Callander.
• Pathology
  Illustraed. Churchill livingstone, 1981.
• 2.   2.    Robin A. Cooke, Brian stewart.
• Colour atlas of
  Anatomical Pathology. Churchill Livingstone, 1995
• 3.  3.  Ramzi S. Cotran, Vinay Kumar, Tucker
  Collins.
• Pathologic Basis of
  Disease. 7th .W.B. Saunders company. 1999.
• 4.    4. Vinay Kumar, Ramzi S. Cotran,
  Stanley L. Robbins.
• Robbins Basic
  Pathology. W.B. Saunders company, 2003
• 5.   5. Michael F. Dixon. Aids to
  Pathology 2th. Churchill Livingstone, 1981.
• 6.  6. Su Min et al. GRAPHIC PATHOLOGY(in
  Chinese).
• Shantou University
  Medical College. 2001
• 7. Shantou University Medical College
• 
  Pathologic teaching net
  http//202.192.145.995/
•  

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Examination

• 1. Practice specimens oral test
• description diagnosis
• 2. Paper national test base bank

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