Abstract:
:The pathologists and cytologists who study Papanicolaou smears perform a highly successful cancer screening test in a low-prevalence population. This leads to a mathematically inevitable false-negative error rate even in the most competent professional hands. The US judicial system supports a public expectation of perfect performance by civil and, recently, criminal punishment of error. Lessons are sought from a considerable industrial experience with accident prevention for possible insights into process improvement that might mitigate the risk of false-negative errors. The elements that, by system analysis, contribute to accidents are reviewed, and the conditions that enhance the accident potential are outlined. The cognitive functions and aberrations that are involved in the operator component of error analysis are described. As a result of pathologists' activities in the systematic measurement of laboratory performance for the last half century, the College of American Pathologists' accreditation program and its derivative Clinical Laboratory Improvement Act requirements have already laid out the avenues of error minimalization. There are no lessons from the science of error prevention that can affect the public expectation of zero error in a screening test and the consequent punishment of cytology professionals. A thesis is offered that the problem is society's if its goal is eradication of cervical cancer mortality. A call is made for leadership by a prestigious, nonpathologist, national organization to make the public understand that the current cytology liability issue is primarily a threat to women and the public health. To initiate public dialogue, a mechanism is suggested to protect simultaneously a patient's right of access to the judicial system and the general availability of the Papanicolaou smear to reduce cervical cancer mortality and morbidity.
journal_name
Arch Pathol Lab Medjournal_title
Archives of pathology & laboratory medicineauthors
Derman Hsubject
Has Abstractpub_date
1997-03-01 00:00:00pages
287-91issue
3eissn
0003-9985issn
1543-2165journal_volume
121pub_type
杂志文章,评审abstract::Twenty-eight weanling swine were divided into two groups and fed a basal ration of corn and soybean meal or one containing a high fat and cholesterol supplement. One subgroup of each received 220,000 IU of vitamin D3 per kilogram. Grossly normal areas of the distal abdominal aorta were used for quantitative comparison...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1977-07-01 00:00:00
abstract::A protocol for the pathologic examination and reporting of specimens from patients with carcinoma of the ampulla of Vater has been developed by the Cancer Committee of the College of American Pathologists. The protocol incorporates all basic pathology data of diagnostic and prognostic significance appropriate for the ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract::Calbindin-D28k is a highly conserved 28,000 (dalton) molecular-weight (Mr) calcium binding protein with broad tissue distribution, yet cell-type-specific expression predominantly in subpopulations of central and peripheral nervous system neurons, distal tubular cells of the kidney, and enteric neuroendocrine cells. A ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::Two cases of intraventricular neuroblastomas were compared with cases of intraventricular and hemispheric neuroblastomas that have been reported in the published literature. The following order of tumor subtypes was found in patients with increasing age: hemispheric neuroblastoma, intraventricular undifferentiated neu...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-09-01 00:00:00
abstract::Two alpha-fucose-binding lectins, Ulex europaeus agglutinin I (UEA I) and Lotus tetragonolobus agglutinin, were employed to compare and contrast the distribution of fucosubstance in normal human kidneys and a variety of renal tumors. The study employed a total of 31 kidneys surgically removed for the presence of a var...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::The postmortem tissue distribution of cholesterol precursors, squalene, and methyl sterols was quantitated in ten human subjects by the use of gas-liquid chromatography. Five methyl sterol subfractions were found, with each organ having a pattern of its own. The mean esterification percentage of the methyl sterol mixt...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract:CONTEXT.—:Atypical ductal hyperplasia (ADH) is a challenging diagnosis defined by cytologic and architectural features that carries an increased risk of subsequent carcinoma when diagnosed in isolation. In addition, ADH may secondarily involve benign breast lesions, wherein it carries variable clinical significance. O...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.5858/arpa.2018-0221-RA
更新日期:2018-10-01 00:00:00
abstract::Papillary fibroelastomas are rare and benign cardiac tumors that typically affect the cardiac valves. To the best of our knowledge, the English literature contains only 1 case report of pulmonary valve fibroelastoma diagnosed by echocardiogram and confirmed by surgical resection. There is a paucity of pathology litera...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/0003-9985(2001)125<0933:PVPF>2.0.CO;2
更新日期:2001-07-01 00:00:00
abstract::At autopsy in the past three years, a new complex of CNS lesions has appeared in 54% (50/93) of the brains of premature infant cadavers that have come from our neonatal intensive care unit. This complex consists of necrotizing lesions in the periventricular white matter and in the gray nuclei of the cerebral hemispher...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract:CONTEXT:Mutation status of the KRAS gene identifies a distinct disease subtype of metastatic colorectal carcinoma that does not respond to antibody therapeutics targeting the epidermal growth factor receptor. This is currently the only validated marker in metastatic colorectal carcinoma with a clear implication in trea...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.5858/arpa.2011-0478-RA
更新日期:2012-10-01 00:00:00
abstract::The College of American Pathologists' enzyme survey permits the evaluation of the quality of enzyme analyses in clinical laboratories. Animal source enzymes for lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and creatine kinase are satisfactory as supplements for enzyme survey serum, sinc...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00
abstract::Recent advances in molecular genetics and cancer stem cell biology have shed some light on the molecular basis of melanomagenesis. In this review, we will focus on major genetic alterations in the melanoma, particularly pathways involved in cell proliferation, apoptosis, and tumor suppression. The potential role of me...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/2009-0418-RAR.1
更新日期:2010-12-01 00:00:00
abstract::We report a water-clear cell adenoma of the parathyroid gland, a lesion which to our knowledge has not been described previously. Like its rare but well-described hyperplastic counterpart, water-clear cell hyperplasia, this adenoma is composed of cells with abundant foamy-to-granular cytoplasm and mild nuclear pleomor...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1995-11-01 00:00:00
abstract:CONTEXT:The immunophenotypic profile of basophils is not yet fully established, and the immunophenotypic changes in chronic myelogenous leukemia are not fully characterized. OBJECTIVE:To establish a comprehensive immunophenotypic spectrum of normal basophils and to assess the range of immunophenotypic aberrations of b...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/1543-2165(2008)132[813:ISOBBM]2.0.CO;2
更新日期:2008-05-01 00:00:00
abstract::Ergotamine has been associated with numerous vascular complications but only rarely with fibrosing disorders or valvular heart disease. Two patients are described in whom severe valvular dysfunction developed during ergotamine therapy for migraine headache. The surgically excised mitral and aortic valves were involved...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00
abstract::We report the case of an adrenal cortical carcinoma with glandular and squamous differentiation, demonstrated by light and electron microscopy as well as by immunohistochemical studies. The patient was a 63-year-old man presenting with a large adrenal mass and markedly increased 24-hour urine metanephrine, initially s...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:CONTEXT:The role of pathologists' assistants (PAs) in terms of surgical and autopsy prosection has been well established; however, the role of PAs in areas beyond surgical and autopsy pathology, such as laboratory administration and management, education, and research, is not so well understood. OBJECTIVE:To determine...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.5858/arpa.2011-0629-OA
更新日期:2012-12-01 00:00:00
abstract:CONTEXT:Diagnostic use of immunohistochemistry has been extensively studied in prostate needle biopsy, but its use in routine practice and the quality assurance and associated cost have not been previously addressed. OBJECTIVE:To examine the routine use of immunohistochemistry in prostate biopsies in a tertiary academ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.5858/arpa.2012-0145-OA
更新日期:2013-04-01 00:00:00
abstract::The autopsy is receiving renewed emphasis as a tool for quality assurance in clinical medicine. Postmortem blood cultures frequently are taken during the autopsy but are costly and of unclear diagnostic utility. To assess whether postmortem blood cultures contribute any useful information not already known from antemo...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::Allogeneic marrow transplants from genotypically HLA-identical siblings have become lifesaving therapy for patients with various congenital and acquired diseases of the immune and hematopoietic systems. Unfortunately, less than 30% of patients in the United States have an HLA-identical sibling; therefore, many are den...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract::The ability of the College of American Pathologists Microbiology Surveys subscriber laboratories to perform antimicrobial susceptibility testing accurately has improved slightly since 1984. Currently (1989 surveys), the accuracies for disk diffusion and minimum inhibitory concentration antimicrobial susceptibility tes...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract::We studied a case of Sturge-Weber syndrome in a 66-year-old woman, who displayed associated angiomas of the thyroid gland and choroid plexi and leptomeningeal melanosis. These findings are discussed in light of the proposed pathogenesis of the syndrome and its relationship to the other neuroectodermal dysplasias. ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1982-02-01 00:00:00
abstract::Changes in bile canaliculi (BCs) after bile duct ligation (BDL) are heterogeneous throughout the liver lobule. Male Wistar rats were killed five hours, 20 hours, four days, or eight days after BDL, and BCs were counted according to their shape (1, normal; 2, elongated with microvilli; 3, dilated, devoid of microvilli;...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1982-09-01 00:00:00
abstract::We report a case of gastric myeloid metaplasia in an 89- year-old woman with agnogenic myeloid metaplasia. The lesions were fortuitously discovered on upper endoscopy. The antral mucosa was thickened and polypoid, and on histologic examination contained immature granulocytes, megakaryocytes, and a few erythroblasts wi...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/1543-2165(2004)128<568:GMMACR>2.0.CO;2
更新日期:2004-05-01 00:00:00
abstract:CONTEXT:Fear that damaging information from autopsy may be introduced as evidence in lawsuits alleging medical malpractice is often cited as one factor contributing to the decline in autopsy rates. OBJECTIVE:To determine how autopsy information influences the outcome of medical malpractice litigation. DESIGN:We studi...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/0003-9985(2002)126<1023:TROTAI>2.0.CO;2
更新日期:2002-09-01 00:00:00
abstract:CONTEXT:The pancreas gives rise to an array of distinct neoplasms that can be solid, cystic, or intraductal and can recapitulate the various lines of differentiation present in the normal gland. OBJECTIVE:To develop an algorithmic approach to the diagnosis of pancreatic neoplasms that simplifies their pathologic evalu...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/1543-2165-133.3.454
更新日期:2009-03-01 00:00:00
abstract:CONTEXT:Autopsy continues to provide important data for quality assurance, teaching, scientific purposes, and health planning, especially if performed according to a comprehensive protocol. OBJECTIVE:To describe and analyze data from all perinatal and pediatric autopsies performed at a university hospital in Brazil. ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/1543-2165(2006)130[62:ROPAPA]2.0.CO;2
更新日期:2006-01-01 00:00:00
abstract::Atherosclerosis can be defined as a disease process that occurs when the influx and deposition of cholesterol into the arterial wall exceed the egress of cholesterol from the arterial wall. This process is characterized by early deposition of cholesterol in and around arterial wall cells. The cholesterol is derived fr...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1983-08-01 00:00:00
abstract::A female infant exposed in utero to anticonvulsant therapy had bilateral encephaloceles, ventricular abnormalities, and defective neuronal migration. This is one of a few articles with pathologic data available that discusses central nervous system involvement in infants exposed to anticonvulsants. ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract:CONTEXT:Relatively little is known about estrogen receptor (ER) expression in papillary urothelial carcinoma (PUC) of the bladder. Greater understanding of this feature of PUCs could aid with the treatment and identification of the origin of metastases, particularly with relation to the morphologically similar entity o...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/1543-2165(2005)129<194:EREIPU>2.0.CO;2
更新日期:2005-02-01 00:00:00