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

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