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PathologyPathologyIntroductionIntroduction
Su MinSu MinDepartment of pathologyDepartment of pathology
Shantou University Medical CollegeShantou University Medical College
Why should we study pathology? Why should we study pathology? Students often ask me this questionStudents often ask me this question in the classin the class
I also have a question to ask youI also have a question to ask you Why did you come here?Why did you come here?
The your goal is very clearlyThe your goal is very clearly
want to be Medical Doctor!want to be Medical Doctor!
Severe Acute Respiratory Syndrome (SARS) make a surprise attack on people anybody could stand aside except medical staffers
Quoted from 21cn.com
Cure Severe Acute Respiratory Syndrome (SARS) patient (extracted from 21cn.com) Angell: heal the wounded and rescue the dying
Quoted from 21cn.com
QuestionQuestion
Patients just want to know:Patients just want to know:
What disease am I suffering from?What disease am I suffering from?
How to cure it?How to cure it?
The key point of medical scienceThe key point of medical science
To prevent To prevent
To diagnose To diagnose DiseaseDisease To treat To treat ( Control) ( Control)
What is Pathology (Pathologia)What is Pathology (Pathologia)
Prefix: Path(pathos) means suffering, disease
Postfix: Ology(logos) means study, science
The concept of pathologyThe concept of pathology
Pathology is the scientific study of disease.
The contents of pathologyThe contents of pathology the causes (aetiology ) mechanisms (Pahogenesis) pathologic changes: structural & funcional abnormalities the descriptions of the manifestations its progress and sequels.
1. Causes of disease1. Causes of disease1). Genetic factors1). Genetic factors(1)(1) Abnormal the chromosomes and component genesAbnormal the chromosomes and component genes Occur spontaneously (or without known cause); Occur spontaneously (or without known cause); In some cases, radiations, chemical or infective agents can be In some cases, radiations, chemical or infective agents can be
incriminated. incriminated.
(2) Susceptibility to some diseases(2) Susceptibility to some diseases
Genetic polymorphisms among or between individuals, Genetic polymorphisms among or between individuals, families, or races strongly influence susceptibility and families, or races strongly influence susceptibility and resistance to diseaseresistance to disease
Quoted from Dr. T.M. Schroeder-Kurth
congenital mentally retarded children
Quoted from Dr. Vogel. Motulsky Human Genetics
2). Environmental factors2). 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
Although the causes of disease are divided into above two main groups, but both groups are interlaced in
most disease.
2. 2. Pathogenesis Means Mechanisms: Most are still investigating. Some of them should be known, for instance: Thrombosis Myocardial infarction
3. Pathologic changes3. Pathologic changes
Level A. Naked eye level:Naked eye level:
gross changes in diseased organs.gross changes in diseased organs.
Level B. Light microscopic level: Light microscopic level:
in histological and cytological level. in histological and cytological level.
Level C. Electron-microscopic(EM) levelElectron-microscopic(EM) level: :
in the ultrastructure (cellular organelles).in the ultrastructure (cellular organelles).
Level D. Molecular level:Molecular level:
inspect aberrant in DNA, RNA, and protein.inspect aberrant in DNA, RNA, and protein.
4. M4. Manifestations
Clinical significanceClinical significance: :
The functional consequences of The functional consequences of the morphologic changes.the morphologic changes.
5. 5. Progress and sequels ProgressProgress simple intricatesimple intricate short-term long-termshort-term long-term
SequelsSequels healinghealing un-healing: delay & complicationsun-healing: delay & complications spread even deathspread even death
Investigation of diseaseInvestigation of disease
In medical practice the objective of the In medical practice the objective of the study of disease is study of disease is twofoldtwofold..
To determine the nature of the disease for establishing a diagnosis.
To control the extent and progress of the disease for treating.
The classification of pathologyThe classification of pathology General pathology: A discussion of disease fundamentals orie
nted 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
The location and importance of The location and importance of pathology in medical educationpathology in medical education
Pathology is a bridge between basic science and clinical Pathology is a bridge between basic science and clinical medicine. All of the medical students have to stride over the medicine. All of the medical students have to stride over the bridge!bridge!
Methods in pathologyMethods in pathology
AutopsyAutopsy:: An examination of a dead body was done by cutting it open to discover the cause of death.
Biopsy
Quoted from CIBA COLLECTION MEDICAL ILLUSTRATIONS
An examination of pathologic samples from living body to set up diagnosis
Cellular examination
Animal experimentation
Se-deficiency animal model
National Natural Science
Foundation of China (No. 30170832 )
Su Min, Zhang Rui-Juan et al.
Tissue and cell culture
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.
Neural stem cell National Natural Science Foundation of China (No. 30170832 ) Tian Dong-Ping, Su Min et al.
Immunohistochemistry and immuno-cytochemistry
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
Electron microscopic examination
Atypia of tumor cells(Pleomorphism of nuclei) in CSEC-215 generation 13 EM×3000
Confocal laser scanning microscopic examination
neuron
nuclear division DNA content
Confocal laser scanning microscopy
three-dimensional
In situ hybridizationIn situ hybridization
Chromosome analysis &
Gene clone
Biochip
History and development of pathologyHistory and development of pathology
Humoral PathologyHippocrates (460-377 BHippocrates (460-377 B
C)C)
History and development of pathologyHistory and development of pathology
Organ PathologyMorgagni Morgagni (Italian,1682-1771 DC)(Italian,1682-1771 DC)
History and development of pathologyHistory and development of pathology
CellularPathologyVirchow Virchow (German, 1882-1902 D(German, 1882-1902 D
C)C)
胡正祥 教授( 1896-1968 )
梁伯强 教授 ( 1899-1968 )
Modern Pathology (1920S-)Ultrastructural PathologyUltrastructural PathologyMolecular PathologyMolecular PathologyImmunopathologyImmunopathologyGenetic PathologyGenetic Pathology
How to study pathology Summary
Students should pay a more attention to following six aspects:
Concepts to master: lots of concept is basic lots of concept is basic processes of studying pathology.processes of studying pathology.
Cause(why) + Location (where) +Change(what)Cause(why) + Location (where) +Change(what)
Diseases Pathology Clinical PracticeDiseases Pathology Clinical Practice
Variations of structurefunctionoutsidenormal range
(1) Causes (aetiology)(2) Mechanisms (Pathogenesis)(3) Pathological changes(4) Manifestations(5) Progress and sequels
Diagnosing disease
Treating disease
Preventing disease
MAIN REFERENCEMAIN REFERENCE 1. 1. Alasdair D. T. Govan, Peter S. Macfarlane, Robin Callander. Alasdair D. T. Govan, Peter S. Macfarlane, Robin Callander. Pathology Illustraed. Churchill livingstone, 1981.Pathology Illustraed. Churchill livingstone, 1981.2.2. 2. 2. Robin A. Cooke, Brian stewart. Robin A. Cooke, Brian stewart. Colour atlas of Anatomical Pathology. Churchill Livingstone, 1995Colour atlas of Anatomical Pathology. Churchill Livingstone, 19953.3. 3. 3. Ramzi S. Cotran, Vinay Kumar, Tucker Collins. Ramzi S. Cotran, Vinay Kumar, Tucker Collins. Pathologic Basis of Disease. 7Pathologic Basis of Disease. 7thth .W.B. Saunders company. 1999. .W.B. Saunders company. 1999.4.4. 4. 4. Vinay Kumar, Ramzi S. Cotran, Stanley L. Robbins. Vinay Kumar, Ramzi S. Cotran, Stanley L. Robbins. Robbins Basic Pathology. W.B. Saunders company, 2003Robbins Basic Pathology. W.B. Saunders company, 20035.5. 5. 5. Michael F. Dixon. Aids to Pathology 2Michael F. Dixon. Aids to Pathology 2thth.. Churchill Livingstone, 1981.Churchill Livingstone, 1981.6.6. 6. 6. Su Min et al. GRAPHIC PATHOLOGY(in Chinese). Su Min et al. GRAPHIC PATHOLOGY(in Chinese). Shantou University Medical College. 2001Shantou University Medical College. 2001 7. Shantou University Medical College 7. Shantou University Medical College Pathologic teaching net Pathologic teaching net http://202.192.145.9:95/http://202.192.145.9:95/
ExaminationExamination
1. 1. PracticePractice: : specimens oral testspecimens oral test description + diagnosisdescription + diagnosis
22. Paper. Paper: : national test base banknational test base bank
Apple tree and Newtonian the law of gravity