Neuropathology Blog Hits Million Pageview Mark!

I just noticed today that this blog now has more than one million pageviews since it inception in October 2007. And this marks the 856th post. Cheers!

Neuropathology Blog recognized in latest issue of Brain Pathology

Neuropathology Blog was recently recognized in an editorial in the international journal Brain Pathology, (Volume 20, Number 4, July 2010). Editor Arie Perry (as of today, on faculty at the UCSF pathology department) writes that the blog is "somewhat of a gossip column where one can find the latest news regarding our discipline and the members within it.  For instance, I was amazed not too long ago to find a story about myself and my impending move to the University of California in San Francisco entitled 'Arie Perry Goes West', seemingly within minutes of my accepting the position!  Another blog a few months later entitled 'Perry Rocks: Arie releases neuropathology music CD' similarly appeared almost immediately after I created a website for these educational songs.  How Brian has managed to obtain this information so quickly is astonishing and perhaps, it's best that we don't know all the details of what is readily and quickly available about each of us on the internet." Of course, I could never reveal my secrets, Arie. But let's just say I have several moles at medical centers throughout the country regularly feeding intelligence into my central control center!

Pathology 2.0: The Time Has Come

You may not realize it, but by reading this blog post you are participating in "Pathology 2.0". What is Pathology 2.0? For that, read an edited transcript of remarks made by Dr. Keith J. Kaplan (pictured) at the College of American Pathologists Foundation June 12-14 "Futurescape of Pathology" conference in Rosemont, Illinois. Speaking of things 2.0, today is the opening day of the Health 2.0 conference in San Francisco. Subtitled "User-Generated Healthcare", the conference focuses on the ways in which Web 2.0 technology is being applied to healthcare today. Conference organizers define Health 2.0 on their website as follows: "Our definition is currently focusing on user-generated aspects of Web2.0 within health care but not directly interacting with the mainstream health care system. That means, a) search, b) communities, c) tools for individual and group consumer use. But clearly there are blurring boundaries between all these, and the question of connecting Health 2.0 user-generated content to the wider health care system—which hasn’t exactly adopted Web 1.0 with a flourish—is coming into closer focus as more clinicians and organizations start to use these technologies to communicate with consumers."

College of American Pathologists spotlights blogging pathologists

Neuropathology Blog is mentioned in an article in the June '09 issue of CAP Today, a monthly publication of the College of American Pathologists. The article -- entitled Tapping into an audience: Growing numbers of pathologists engaging in the business of blogging -- focuses on several pathologist/bloggers, including Dr. Bruce Friedman (pictured) and his Lab Soft News blog. Blogging, Friedman says, in no way replaces academic journals or textbooks, but rather fills a different communication niche. "I believe my blog affords me a greater opportunity to disseminate new ideas than my academic writing," he says. Friedman, professor emeritus at the University of Michigan, also likes blogging because it prompts him to review "a wide swath of news covering lab information technology, the clinical lab industry, and health care in general, which I then blog about. Blogging has allowed me to climb out of this very focused academic silo." The final paragraph of the article quotes me as saying that once pathogists embrace the Web 2.0 movement, which includes blogging, "they'll see the benefit of it in terms of creating a global community of pathologists who can learn from each other."

Study sheds light on Huntington disease with implications for other neurodegenerative disorders

A common theme among neurodegenerative diseases is that there is a some kind of "nucleating protein" which aggregates within specific areas of the brain. There is debate as to whether the aggregates cause disease, or are simply an attempt by brain cells to sequester bad proteins. If the former is true, then therapy should be aimed at disaggregating the bad protein. If the latter is true, then therapy should be focused on helping the brain to inactivate the free-floating bad proteins. A recent advance in the understanding of Huntington disease (HD) suggests that the free-floating form of the protein may be the culprit, lending support to the idea that other neurodegenerative diseases like Alzheimer's and Parkinson's may also be caused by soluble proteins rather than the aggregates that we neuropathologists focus on under the microscope.

Scientists have known for some time that HD is associated with a trinucleotide repeat mutation in the protein huntingtin on chromosome 4. But, since huntingtin is present throughout the brain, why does neurodegeneration in HD take place predominantly in the striatum (caudate and putamen)? Solomon H. Snyder and his team at Johns Hopkins University, in the June 5th issue of the journal Science, show that cytotoxicity in HD takes place because of the interaction of mutant huntingtin with a second protein, known as Rhes. It turns out that Rhes is a striatal specific protein, thus explaining the anatomic specificity of neurodegeneration in HD. Snyder and colleagues go on to show that cells in culture tend to sequester mutant huntingtin into an aggregate. But in the presence of Rhes, mutatant huntingtin cannot aggregate, suggesting that the soluble form of the bad protein is what causes damage.

An Associated Press article about the discovery posted on Forbes.com quotes Walter J. Koroshetz of NIH's National Institute of Neurological Disorders and Stroke as follows regarding the implications of this new study: "The answers in one disease may have implications for another... There's been people on both sides of the fence. This story plays to the role of the aggregates as not being the major problem but the soluble protein as being the major problem."

The most famous Huntington patient was the iconic folk singer Woody Guthrie. And it was my colleague Doug W. Shevlin, who writes a pretty widely read music blog which today features a Woody Guthrie song, who alerted me to this break-through study. In a stroke of synchronicity, it so happens that my good friend Mark B. Weiss (pictured) is representing a performer at next month's Woody Guthrie Folk Festival in Okemah, Oklahoma.

Web tools for neuropathology addressed in recent Brain Pathology article

Neuropathology Blog was mentioned in a recent Brain Pathology article by University of Oklahoma neuropathologist Kar-Ming Fung (pictured) and University of California San Francisco neuropathologist Tarik Tihan. Entitled Internet and World Wide Web-Based Tools for Neuropathology Practice and Education (April 2009, 19:2, p 323-331), the article also features Dr. Fung's own extensive website, NeuroLearn.com, which is a self-guided neuropathology teaching tool for students and residents.

Dr. Katie goes to Med School: A nice blog for second year med students

Dr. Katie describes herself as "A 20-something girl trying to balance medical school and real-life". She has a nice blog addressing a variety of things, including issues concerning life as a second-year medical student. Today's post is on Twitter resources for those studying for Step 1 of the USMLE medical licensing boards. Good luck to Katie and everyone else taking Step 1 next month!

Neuropathology Blog Starts Twittering

At the suggestion of the reader Library Staffer, and inspired by Digital Pathology Blog as well as Dr. Doug Shevlin, Neuropathology Blog has gone Twitter. My periodic tweets will appear on this blog in the right-hand column; and, conversely, blog post titles (with a link to the post) will appear on my Twitter account. Twittering is a trend that cannot be resisted: The New York Times calls Twitter "one of the fastest-growing phenomena on the Internet." Who am I to swim against the tide?

The Pool of pathology bloggers increases by one this month

I was gratified to see another pathologist recently join the ranks of bloggers posting about the profession. Dr. Doug Shevlin recently alerted me to the inauguration of a blog by a blue-collar surgical pathologist, Dr. Mark Pool, working in the trenches at a hospital in Kankakee, Illinois. Pool's blog is barely a month old, and has already garnered a mention on the popular Digital Pathology Blog! I can tell you this: I've never seen the word "polyphyletic" used in a blog before -- never, that is, until Dr. Pool's lovely post on reactive urothelium. This Pool is deep!

Happy First Birthday to Neuropathology Blog!

Today marks the first anniversary of Neuropathology Blog! There have been 128 posts in the last year, and over 200 comments by readers. Geographic tracking shows that people from as near as Springfield, IL and as far away as India and Japan have accessed this blog. Also, there have been more than 1,200 views of my profile during the past 12 months. I've enjoyed the experience, and hope that I've provided some education and entertainment along the way. I look forward to the next year of neuropathology blogging!

Polio: Once ubiquitous, now a disease of poverty

Today is Global Blog Action Day ‘08, which this year focuses on the topic of poverty. One important place where poverty and neuropathology intersect is in the disease known as poliomyelitis (polio). This is a highly infectious viral disease, which mainly affects young children. The virus is transmitted through contaminated food and water, facilitated by crowding and poor sanitation. The virus multiplies in the intestine and then can invade the nervous system. In a small proportion of cases, the disease causes paralysis, which is often permanent. Although the spinal cord is usually involved, the distribution of paralysis depends upon the distribution of lesions within the CNS. The paralysis is usually asymmetric and involves the legs more often than the arms.

There is no cure for polio, it can only be prevented through immunization. The introduction in the 1950s of the Salk vaccine and in the early 1960s of the Sabin vaccine caused a sharp decline in the incidence of poliomyelitis. Polio vaccine, given multiple times, almost always protects a child for life.

Histopathologically, neuronophagia is prominent from a very early stage, as lymphocytes and microglia aggregate around dying neurons like vultures around a carcass. (The photomicrograph depicts neuronophagia of a neuron in the inferior olive of a patient with brainstem encephalitis caused by coxsackievirus.) Eventually, only clusters of microglia remain where the neuron once lay. In patients who die years after onset of the illness, autopsy examination of the spinal cord reveals anterior horn neuronal loss and corresponding discoloration of anterior nerve roots.

The World Health Organization (WHO), in collaboration with other agencies, has been working on a global immunization initiative since 1988. The Global Polio Eradication Initiative has been working to immunize children in impoverished regions of the world, where education and health care resources are scarce. The results of this initiative are encouraging: polio cases have decreased by over 99% since 1988 -- from an estimated 350, 000 cases then, to 1,997 reported cases in 2006. In 2008, only four countries in the world remain polio-endemic, down from more than 125 in 1988. The remaining endemic countries are Afghanistan, India, Nigeria and Pakistan.

References:

1. World Health Organization website: http://www.who.int/topics/poliomyelitis/en/

2. Greenfield’s Neuropathology (8^th edition), Love S, Louis DN, and Ellison DW (eds). Edward Arnold Publishers (2008). Chapter 17: Viral Infections. Love S and Wiley CA. pages 1285-1291.

3. Global Polio Eradication Initiative website: http://www.polioeradication.org/

Neuropathology Blog adds a new feature

I’ve added a new gadget which allows you to become part of the public fan base for this blog. Followers allows you to see who else is following this blog, see the blogs they’re writing, and read the other blogs they’re following. It’s a means of organically creating a network of people interested in neuropathology. Readers who become official followers of the blog can have their profile picture displayed in the followers list if they so wish. Finally, this feature allows you to see the blogs I follow by clicking on view my complete profile under my picture in the column on the right. Just click the “follow this blog” link on the right side of this page, and add yourself as a regular reader. Let’s see where this brings us!

Neuropathology Blog initiates new feature

On more than one occasion, I have been discussing something with a colleague and remembered that I had blogged about that very same issue some months previously. Then, in order to find the post, I would have to try to remember when I posted on the subject if I wanted to find the entry in the archives. That was fine back when I had only twenty or thirty posts on this site. Now, I have more than one hundred posts; and finding old posts has become tedious. Not to worry. The people at blogger provide a feature called "labels" which allows me to attach search terms to each of my posts. I have renamed the feature "tags", as it sounds more appropriate to me. From now on, you will see along the right-hand column of the page a list of tags, with the number of posts tagged with a particular subject heading. I know this will make searching the archive much easier. It will take about a week for me to go through each post on the site and make tags for each, but it will eventually make searching this blog a whole lot easier.

There's money in blogging!

The esteemed Dr. Doug Shevlin fowarded me this New York Times article about another guy with an M.D. after his name who blogs. Dr. Arnold Kim, pictured above, writes MacRumors.com, which monitors new developments coming out of the notoriously secretive Apple. Dr. Kim recently quit his day job as a physician, which brought in a six-figure income, to blog full-time, saying "“on paper, it was an easy decision.” Sweet.

'Moore as Lincoln' back in Profile

By popular demand, I have removed the respectable and professional picture on my profile and replaced it with me dressed as Abe Lincoln last February 12th.

Neuropathology Blog takes a holiday

To my dozens of loyal readers out there, I should let you know that I'll not be posting for the next month. William Butler Yeats said that a fulfilled life is one in which there is "a continuous drinking of knowledge". I hate to interrupt the imbibing; but I promise to return with a tall glass of neuropathology on June 30, 2008. In the meantime, may your hippocampi continue to be stimulated elsewhere!

I'm not the only path-poster in the blogosphere!

One of my favorite pathology blogs is published by Ole Eichhorn, Chief Technical Officer of Aperio Technologies, a digital pathology company in San Diego. Eichhorn’s blog, The Daily Scan (http://blog.aperio.com/), covers news and offers opinions about pathology, technology, and the interface between the two. A related blog, Digital Pathology Blog (www.tissuepathology.typepad.com), addresses issues pertaining to telemedicine and image technology.

Dr. Bob Struble, of SIU School of Medicine, had this to say....

"Your picture just needs a long stem pipe and you would look like a acromegalic leprechan. Is this any way to present the backwater of neuropathology to the rest of the sentient universe?
:-D"
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Inauguration of the new blog about neuropathology

This is the first entry in a blog that will focus on the practice of neuropathology. The focus will be on issues raised in practice, and less on experimental neuropathology. I will comment on recent articles, discuss neuropathology trivia, gossip about other neuropathologists, and so on. I hope you enjoy it.