Thursday, December 31, 2009
Monday, December 28, 2009
A new edition of the canonical Robbins and Cotran Pathologic Basis of Disease appeared recently and is no doubt being widely purchased by second-year medical students throughout the country as they begin the academic year later this month. I emailed the authors of the neuropathology-related chapters and asked them what was new and improved about the 8th edition. First, Douglas C. Anthony, MD, PhD of the University of Missouri Pathology Department (pictured below), who co-authored the chapters on the peripheral and central nervous systems with Drs. Matthew Frosch and Umberto DiGirolomi, had the following to say about the the new edition:
Next, I contacted Robert Folberg, MD (pictured below), ophthalmic pathologist and dean of the Oakland University William Beaumont School of Medicine in Michigan, for his take on the chapter he authored on the eye. His statement follows:
"The major revision [in the eye chapter] was the jump between the 6th and 7th edition. The chapter was revised completely during the 6-7 edition transition. The current chapter is a bit shorter - as are most chapters in the book - and the references and some concepts have been updated. There are no 'earth-shattering' changes between [the 7th and 8th editions]."
There you have it. I am sure I can speak for all of the readers of this new edition, both students and faculty alike, in expressing my appreciation for the countless hours of work that went into creating this text. I look forward to diving into it as the new academic year begins!
Monday, December 21, 2009
Thursday, December 17, 2009
Wednesday, December 16, 2009
Sunday, December 13, 2009
And now, a few questions for our featured fan:
Why are you interested in the neurology of cats and dogs?
"My interest in neurology started when I realized what a neglected field neurology was in veterinary medicine. I do believe that these patients deserve a diagnosis... Besides, neurology is extremely fascinating and it involves both medicine and surgery (at least in veterinary medicine where I am able to do both)."
What role can human neuropathologists play in the work that you do?
"A neuropathologist would be a dream come true for me!! I stuggle to find someone interested to make an effort to examine these patients properly and with enthusiasm. I know it is difficult for a general pathologist to interpret changes in the nervous system and I sometimes get very obscure and not always accurate pathology reports. I also want to be able to do reasearch and it is difficult to find someone (also abroad) to have the time and interest. I would like to know enough to not be so dependent on pathologists who are not really neuropathologists. I also want to learn to get a better general picture of my cases."
I see from your curriculum vitae that you are particularly interested in canine and feline motor neuron diseases. Do you want to hear from neuropathologists who share your research interests? If so, how should they contact you?
Yes! I can be reached via email at: firstname.lastname@example.org
Thanks for reading Neuropathology Blog, Dr. Rohdin. And thanks for the work you do in helping to relieve the suffering of our fellow mammals!
Thursday, December 3, 2009
Wednesday, December 2, 2009
Monday, November 30, 2009
reports that a daguerreotype depicting Phineas Gage has been discovered. In the next issue of the Journal of the History of the Neurosciences, an article establishing the identity of the man holding an iron rod (see photo above) is that of Mr. Gage. This is the only known photograph of perhaps the most legendary neurology patient in history. To illustrate the executive function orchestrated by the prefrontal lobes, medical students throughout the country are told the story of the railroad construction foreman Phineas Gage, who, in 1848, suffered an accident on the job which resulted in a 13-pound iron rod shooting through the front of his brain. Gage survived the accident, and lived 11 years more. But he was never the same, exhibiting "frontal release" signs characterized by disinhibition and impulsivity.
The photograph was discovered by Jack and Beverly Wilgus, a couple from Massachusetts who owned the photograph for 30 years, thinking it depicted a whaler holding a harpoon. When they posted the picture online, an anonymous tipster suggested it might be Gage. The LA Times article continues the story: "Intrigued, the Wilguses compared their image to that of a life mask at Harvard Medical School's Warren Anatomical Museum and found it could be superimposed perfectly, with scars lining up correctly. Apparent writing on the metal rod in the image matches writing on Gage's iron rod, which is also in the Warren Museum."
Tuesday, November 17, 2009
Tuesday, November 10, 2009
Wednesday, November 4, 2009
Tuesday, October 27, 2009
"The field of forensic neuropathology has expanded exponentially over the past few years and has seen the publication several new text books and the development of a one-year fellowship position in some medical examiner offices. With this growth the practicing neuropathologist who handles forensic brains needs to keep up with current research. In light of this, I proposed to Dr. David Louis (the current president of the American Association of Neuropathologists) that the upcoming AANP meeting have a dedicated forensic neuropathology session. Dr. Louis agreed and charged me with the task of drumming up interested individuals. Even though the area of forensic neuropathology has seen tremendous growth, it seems as though those of us practicing the 'dark art' are out of touch with each other. I have managed to get in touch with a few folks and have hopes of finding more of us forensic NPer's. My goal is to get people interested in submitting forensic-related abstracts for the June 2010 AANP meeting in Philadelphia. The submission deadline is February 5, 2010, so there is plenty of time. According to the powers-that-be at AANP, right now I have enough people for a dedicated poster session. If more people are interested, we could get a platform session. A formal decision will not be made regarding a poster or platform session until all of the abstracts are submitted. So, if you are interested, get in touch with me (at email@example.com) so I can get a head count (no pun intended, but appreciated if you thought it was punny). Also, if you are practicing forensic neuropathology to any degree, still get in touch with me even if you don't want to prepare an abstract. I would like to hear from you. OK, lets get those abstracts cooking, there is power in numbers!!"
Wednesday, October 21, 2009
You might counter that this is simply the result of a few bad-luck hits on the field, but research involving the University of North Carolina football team suggests otherwise. Players at UNC wear impact sensors in their helmets throughout the season. Results from these investigations suggests that even routine hits during practice can add up to cause concussions and, theoretically, set the stage for chronic traumatic encephalopathy. (On the first day of training camp one UNC lineman was recorded as having been hit in the head thirty-one times!)
Back in 1905, Gladwell reports, the question of whether football should be played in our nation's schools was raised to the level of the White House, when President Theodore Roosevelt called an emergency summit to discuss the issue. At the time, a professor at the University of Chicago called football a "boy-killing, man-mutilating, money-making, education-prostituting, gladiatorial sport". And in December of 1905, presidents of twelve prominent colleges met in New York and came within one vote of abolishing the sport at their institutions.
What does this mean for football in America? Nothing. Fans are willing to spend a lot of money to see men slam into each other's heads on the field. But, as a parent, you can do something. You can forbid your son from playing football.
Wednesday, October 14, 2009
Wednesday, October 7, 2009
Tuesday, October 6, 2009
Friday, October 2, 2009
Monday, September 28, 2009
Baylisascaris procyonis is an intestinal roundworm endemic to the US raccoon population. Humans are infected by ingestion of worm eggs in raccoon feces. The median age for human infection is just over one year old, consistent with the propensity of young children to explore their environment orally (surprising that this behavior has not been naturally selected out of humans over the millenia!). I came across only one report of clinical recovery after infection (reference 2). Otherwise, cerebral Baylisascariasis results in either severe neurologic damage or death. That being said, subclinical infection has been suggested by a study in Chicago, which found 30 (8%) of 389 children 1–4 years of age were seropositive for B. procyonis, although none had experienced symptoms (reference 3).
The most common cause of eosinophilic meningitis in the United States is the presence of a ventriculoperitoneal shunt; but worldwide it is infection by Angiostrongylus cantonensis. In addition to Bayliscaris procyonis, other infectious causes of eosinophilic meningitis include Toxocara spp., Gnathostoma spinigerum, and neurocysticercosis (source: reference 2).
1. Love S, et al, eds. Greenfield's Neuropathology, 8th edition. p. 1479.
2. Pai et al. Full recovery from Baylisascaris procyonis eosinophilic meningitis. Emerging Infectious Disease 13(6) p 928-30. June 2007
3. Brinkman WB, Kazacos KR, Gavin PJ, Binns HJ, Robichaud JD, O'Gorman M, et al. Seroprevalence of Baylisascaris procyonis (raccoon roundworm) in Chicago area children. In: Program and abstracts of the 2003 Annual Meeting of the Pediatric Academic Societies, Seattle, Washington; 2003 May 3–6. Abstract 1872. [cited 2007 Mar 29]. Available from http://www.abstracts2view.com/pasall/authorindex.php
Wednesday, September 23, 2009
Today I profile Dr. Craig Horbinski (pictured), a rising star in the neuropathology firmament. If you follow the neuropathology literature, you are sure to hear about Craig in the coming decades as he sure to make a big impact on the field. After a short biographical sketch, Craig answers a few of my questions:
Craig Horbinski hails from snowy Buffalo, NY, where he did both his undergraduate training in Biology at Canisius College and a combined MD, PhD at the State University of New York at Buffalo. Craig’s work as a graduate student was on mechanisms of dendrite growth, requiring a lot of microscopy and morphometric analyses. After a 1-year postdoctoral research fellowship studying Parkinson Disease at the University of Pittsburgh, he did 3-year Anatomic Pathology residency at UPMC. During this time Craig developed an interest in oncogenesis, particularly as his residency training exposed him to cutting-edge molecular diagnostic approaches to neoplasms. Thus, when continuing his training as a fellow in neuropathology at Pitt, he focused his research on both the molecular diagnostics of gliomas and mechanisms underlying gliomagenesis, as well as the application of telemedicine to neuropathology. Upon completion of his neuropathology fellowship in July of 2009, Craig joined the faculty at the University of Kentucky in Lexington as an Assistant Professor in Neuropathology, where he is continuing his work on gliomagenesis and molecular diagnostics as an independent principal investigator. Craig is married to Christy and has a 1-year old son, Cedric. He and Christy are slated to adopt a baby from China, probably by early 2010.
1. Why did you decide to become a neuropathologist?
I’ve been attracted to the neurosciences since my sophomore year of college, which featured a fantastic course on neurobiology. Since I was already committed to being a physician, I thought neurology was the way to go (neurosurgery was out of the question). But as I went through medical school I discovered the field of pathology, in particular neuropathology. To me it seemed the best way to scratch both the research and clinical itches (so to speak), as neuropathology lends itself particularly well to those with combined-degree training.
2. Name a couple of important professional mentors. Why were they important to you?
The first person I have to acknowledge is Dennis Higgins, my thesis advisor back at SUNY Buffalo. He was a real gem, a pure scientist whose passion for science was both inspiring and infectious. It’s not an exaggeration to say I learned how to think like a scientist from him. Tragically he died of pancreatic cancer a few years ago; I think he would have been pleased to see how things have gone for me thus far. The second key person is Clayton Wiley, the Director of Neuropathology at the University of Pittsburgh. While I learned science from Dennis, I learned grantsmanship and administration from Clayton. He’s one of those exceedingly rare people who managed to succeed at all four pillars of an academic physician’s life: research, clinical, administration, and teaching. Plus he’s mastered the art of staying out of political brouhahas—not a trivial accomplishment in a big academic center. Even more intolerable is that he’s a terrific guy, very approachable, with a sharp, self-deprecating wit. Anyone who wants to know how to survive as a physician-scientist ought to emulate Clayton.
3. What advice would you give to a pathology resident interested in doing a neuropathology fellowship?
Be sure you are flexible with where you want to live. The job market for neuropathology is pretty good right now, but since brain tumors are relatively uncommon, only medium-to-large cities can typically sustain neuropathologists. That is, unless you are planning on doing full-time clinical, with some general surgical path mixed in. Another word of caution goes to those who want to develop an independent research program—most academic neuropath openings will claim they want you to do independently-funded research, but beware of red flags like being asked to commit 50% or more of your time to clinical work “until you get a grant” (which probably won’t happen if you’re devoting that much time to clinical), or splitting your clinical time between neuropath and general surgical path.
4. What city (other than Lexington, KY of course) would you like a future American Association of Neuropathologists meeting to be held and why?
I think Salt Lake City would be a neat change of pace from the typical destinations. It’s fairly easy to fly to, it’s relatively inexpensive, the weather’s good in June, and the mountain scenery is gorgeous.