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 Methods used in pathology • 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) 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) History of pathology • 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) 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) Organization of education • 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) Good luck !