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Pathology Introduction Su Min Department of pathology Shantou University Medical College 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! 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 Question Patients just want to know: What disease am I suffering from? How to cure it? The key point of medical science To prevent To diagnose To treat ( Control) Disease What is Pathology (Pathologia) Prefix: Path(pathos) means suffering, disease Postfix: Ology(logos) means study, science The concept of pathology Pathology is the scientific study of disease. The the contents of pathology causes (aetiology ) mechanisms (Pahogenesis) pathologic changes: structural & funcional abnormalities the descriptions of the manifestations its progress and sequels. 1. Causes of disease 1). Genetic factors (1) 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 oted from Dr. T.M. Schroeder-Kurth congenital mentally retarded children Quoted from Dr. Vogel. Motulsky Human Genetics 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 Although the causes of disease are divided into above two main groups, but both groups are interlaced in most disease. 2. Pathogenesis Means Mechanisms: Most are still investigating. Some of them should be known, for instance: Thrombosis Myocardial infarction 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. 4. Manifestations Clinical significance: The functional consequences of the morphologic changes. 5. Progress and sequels Progress simple short-term intricate long-term Sequels healing un-healing: delay & complications spread even death 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. 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 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! Methods in pathology Autopsy: 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 RuiJuan 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 cytochemistry and immuno- 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 Confocal laser scanning microscopy neuron three-dimensional nuclear division DNA content In situ hybridization Chromosome analysis & Gene clone Biochip History and development of pathology Humoral Pathology Hippocrates (460-377 BC) History and development of pathology Organ Pathology Morgagni (Italian,1682-1771 DC) History and development of pathology CellularPathology Virchow (German, 1882-1902 DC) 胡正祥 教授 (1896-1968) 梁伯强 教授 (1899-1968) Modern Pathology (1920S-) Ultrastructural Pathology Molecular Pathology Immunopathology Genetic Pathology 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) Diseases Variations of structure function outside normal range Pathology Clinical Practice (1) Causes (aetiology) (2) Mechanisms (Pathogenesis) (3) Pathological changes (4) Manifestations (5) Progress and sequels Diagnosing disease Treating disease Preventing disease 2. 3. 4. 5. 6. MAIN REFERENCE 1. Alasdair D. T. Govan, Peter S. Macfarlane, Robin Callander. Pathology Illustraed. Churchill livingstone, 1981. 2. Robin A. Cooke, Brian stewart. Colour atlas of Anatomical Pathology. Churchill Livingstone, 1995 3. Ramzi S. Cotran, Vinay Kumar, Tucker Collins. Pathologic Basis of Disease. 7th .W.B. Saunders company. 1999. 4. Vinay Kumar, Ramzi S. Cotran, Stanley L. Robbins. Robbins Basic Pathology. W.B. Saunders company, 2003 5. Michael F. Dixon. Aids to Pathology 2th. Churchill Livingstone, 1981. 6. Su Min et al. GRAPHIC PATHOLOGY(in Chinese). Shantou University Medical College. 2001 7. Shantou University Medical College Pathologic teaching net http://202.192.145.9:95/ Examination 1. Practice: specimens oral test description + diagnosis 2. Paper: national test base bank Apple tree and Newtonian the law of gravity