臨床病理学、臨床病理

WordNet

a healthcare facility for outpatient care
a medical establishment run by a group of medical specialists
meeting for diagnosis of problems and instruction or remedial work in a particular activity
scientifically detached; unemotional; "he spoke in the clipped clinical monotones typical of police testimony"
relating to a clinic or conducted in or as if in a clinic and depending on direct observation of patients; "clinical observation"; "clinical case study"
any deviation from a healthy or normal condition
the branch of medical science that studies the causes and nature and effects of diseases

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〈U〉(医学の)臨床講義 / 〈C〉《集合的に》臨床講義のクラス / 〈C〉臨床講義室 / 〈C〉(病院・医科大学・社会事業団などに付属した)診療所;《形容詞を判って》医療施設,病院 / 〈C〉(警察・学校・社会事業団などに付属した)相談所
臨床の,臨床講義の / 病床の / 臨床的な,客観的な態度の
〈U〉病理学 / 〈C〉〈U〉病理,病状

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/08/20 17:39:55」(JST)

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Hematology: Blood smears on a glass slide, stained and ready to be examined under the microscope.

Hematology: microscopic image of a normal blood smear. a:erythrocytes, b:neutrophil, c:eosinophil, d:lymphocyte.

Bacteriology: Agar plate with bacterial colonies.

Bacteriology: microscopic image of a mixture of two types of bacteria stained with the Gram stain.

Clinical chemistry: an automated blood chemistry analyser.

Clinical chemistry: microscopic image of crystals in urine.

Clinical pathology (US, UK, Ireland, Commonwealth, Portugal, Italy), Laboratory Medicine (Germany, Romania, Poland, Eastern Europe), Clinical analysis (Spain) or Clinical/Medical Biology (France, Belgium, Netherlands, Austria, North and West Africa...),^[1] is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids, such as blood, urine, and tissues using the tools of chemistry, microbiology, hematology and molecular pathology. This specialty requires a medical residency and should not be confused with Biomedical science, which is not necessarily related to medicine.

1 Licensing and subspecialties
2 Organization
- 2.1 In United States of America
- 2.2 In Europe
3 Place of work
4 Tools of Clinical Pathology
- 4.1 Macroscopic examination
- 4.2 Microscopical examination
- 4.3 Analyzers
- 4.4 Cultures
- 4.5 Values known as “normal” or reference values
5 See also
6 References
7 External links

Licensing and subspecialties

The American Board of Pathology certifies clinical pathologists, and recognizes the following secondary specialties of clinical pathology:

Chemical pathology, also called clinical chemistry
Hematopathology
Blood banking - Transfusion medicine
Clinical microbiology
Cytogenetics
Molecular genetics pathology.

In some countries other subspecialties fall under certified Clinical Biologists responsibility ^[2] :

Assisted reproductive technology, Sperm bank and Semen analysis
Immunopathology

Organization

Clinical pathologists are often medical doctors. In some countries in South-America, Europe, Africa or Asia, this specialty can be practiced by non-physicians, such as Ph.D or Pharm.D after a variable number of years of residency.

In United States of America

Clinical pathologists work in close collaboration with clinical scientists (clinical biochemists, clinical microbiologists, etc.), medical technologists, hospital administrators, and referring physicians to ensure the accuracy and optimal utilization of laboratory testing.

Clinical pathology is one of the two major divisions of pathology, the other being anatomical pathology. Often, pathologists practice both anatomical and clinical pathology, a combination sometimes known as general pathology. Similar specialties exist in veterinary pathology.

Clinical pathology is itself divided in to subspecialties, the main ones being clinical chemistry, clinical hematology/blood banking, hematopathology and clinical microbiology and emerging subspecialities such as molecular diagnostics and proteomics. Many areas of clinical pathology overlap with anatomic pathology. Both can serve as medical directors of CLIA certified laboratories. This overlap includes immunoassays, flow cytometry, microbiology and cytogenetics and any assay done on tissue. Overlap between anatomic and clinical pathology is expanding to molecular diagnostics and proteomics as we move towards making the best use of new technologies for personalized medicine.^[3]

In Europe

Recently, EFCCLM has chosen the name of "Laboratory medicine specialist" to define all European Clinical pathologists, regardless of their training (M.D, Ph.D or Pharm.D) ^[4].

In France, Clinical Pathology is called Medical Biology ("Biologie médicale") and is practiced by both M.D.s and Pharm.Ds. The residency lasts four years. Specialists in this discipline are called "Clinical Biologist" rather than "Clinical pathologist".^[5]

Place of work

See Medical laboratory.

Tools of Clinical Pathology

Microscopes, analysers, strips, centrifugal machines...

Macroscopic examination

The visual examination of the taken liquid is a first main indication for the pathologist or the physician. The aspect of the liquid, in addition, conditions the analytical assumption of responsibility that follow and the validity of the end-results.

Microscopical examination

Microscopic analysis is an important activity of the pathologist and the laboratory assistant. They have many different colourings at their disposal (GRAM, MGG, Grocott, Ziehl-Neelsen, …). Immunofluorescence, cytochemistry, the immunocytochemistry and FISH are also used in order make a correct diagnosis.

This stage allows the pathologist to determine the character of the liquid: “normal”, tumoral, inflammatory even infectious. Indeed, microscopic examination can often determine the causal infectious agent, in general a bacterium, a mould, a yeast, or a parasite, more rarely a virus.

Analyzers

See Automated analyser.

The analysers, by the association of robotics and spectrophotometry, allowed these last decades a better reproducibility of the results of proportionings, in particular in medical biochemistry and hematology.

The companies of in vitro diagnosis henceforth try to sell chains of automats, i.e. a system allowing the automatic transfer of the tubes towards the various types of automats of the same mark. These systems can include the computer-assisted management of a serum library.

These analysers must undergo daily controls to guarantee a result just possible, one speaks about quality control. These analysers must also undergo daily, weekly and monthly maintenances.

Cultures

A big part of the examinations of clinical pathology, primarily in medical microbiology, use culture media. Those allow, for example, the description of one or several infectious agents responsible of the clinical signs.

Values known as “normal” or reference values

Detailed article: Reference range.

References

^ Name of specialization in clinical pathology in different European countries
^ Sub-specialties and Curriculum content of Clinical pathology specialization in France
^ Description of Pathology in USA
^ "Laboratory medicine specialist in EFCC newsletter may 2011 (page 5)
^ Reglementation for French Residency in Clinical Pathology

External links

American Society for Clinical Pathology
American Board of Pathology
College of American Pathologists

UpToDate Contents

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4. 軽度認知機能障害：疫学、病理学、および臨床的評価 mild cognitive impairment epidemiology pathology and clinical assessment
5. 特発性間質性肺炎：臨床症状および病理 idiopathic interstitial pneumonias clinical manifestations and pathology

English Journal

Development of a novel protein biochip enabling validation of immunological assays and detection of serum IgG and IgM antibodies against Treponema pallidum pathogens in the patients with syphilis.

Huang NL1, Ye L1, Schneider ME2, Du YX2, Xu YH3, Fan LB1, Du WD4.
Biosensors & bioelectronics.Biosens Bioelectron.2016 Jan 15;75:465-71. doi: 10.1016/j.bios.2015.08.036. Epub 2015 Sep 3.
In this study, we developed a novel protein biochip methodology that was characterized by dithiobis (succinimidyl undecanoate) (DSU) and specialized for detection of serum IgG and IgM antibodies against Treponema pallidum pathogens in the patients with syphilis, respectively. The biochips were valid
PMID 26364122

Behavioral despair associated with a mouse model of Crohn's disease: Role of nitric oxide pathway.

Heydarpour P1, Rahimian R2, Fakhfouri G3, Khoshkish S1, Fakhraei N4, Salehi-Sadaghiani M1, Wang H5, Abbasi A6, Dehpour AR7, Ghia JE8.
Progress in neuro-psychopharmacology & biological psychiatry.Prog Neuropsychopharmacol Biol Psychiatry.2016 Jan 4;64:131-41. doi: 10.1016/j.pnpbp.2015.08.004. Epub 2015 Aug 9.
Crohn's disease (CD) is associated with increased psychiatric co-morbidities. Nitric oxide (NO) is implicated in inflammation and tissue injury in CD, and it may also play a central role in pathogenesis of the accompanying behavioral despair. This study investigated the role of the NO pathway in beh
PMID 26268932

The Role of Matricellular Proteins in Brain Edema after Subarachnoid Hemorrhage.

Suzuki H1, Fujimoto M2, Shiba M2, Kawakita F2, Liu L2, Ichikawa N2, Kanamaru K3, Imanaka-Yoshida K4, Yoshida T4.
Acta neurochirurgica. Supplement.Acta Neurochir Suppl.2016;121:151-6. doi: 10.1007/978-3-319-18497-5_27.
Accumulated evidence suggests that blood-brain barrier disruption or brain edema is an important pathologic manifestation for poor outcome after aneurysmal subarachnoid hemorrhage. Many molecules may be involved, acting simultaneously or at different stages during blood-brain barrier disruption via
PMID 26463940

Japanese Journal

Reendothelialization of Human Heart Valve Neoscaffolds Using Umbilical Cord-Derived Endothelial Cells

Weymann Alexander,Schmack Bastian,Okada Takayuki,Soós Pál,Istók Roland,Radovits Tamás,Straub Beate,Barnucz Enikö,Loganathan Sivakkanan,Pätzold Ines,Chaimow Nicole,Schies Carsten,Korkmaz Sevil,Tochtermann Ursula,Karck Matthias,Szabó Gábor
Circulation Journal 77(1), 207-216, 2013
… The in vitro construction of tissue-engineered heart valves based on decellularized human matrices followed by endothelialization using HUVECs is a feasible and safe method, leading to the development of future clinical strategies in the treatment of heart valve disease. (Circ J 2013; …
NAID 130001870111

<Original article> Sphingosine 1-phosphate stimulates cell migration and active seprase expression in human endothelial cells

Okamoto Hirotaka,Yatomi Yutaka,Satoh Kaneo,Yamane Tetsu,Mitsumata Masako,Chen Wen-Tien,Ozaki Yukio,Fujii Hideki
山梨医科学雑誌 27(1), 31-41, 2013
NAID 110009554874

アルコール依存症とWernicke's encephalopathy(<特集>ビタミンB_1による認知症の予防・治療)

松井敏史,櫻井秀樹,遠山朋海,吉村淳,松下幸生,樋口進
ビタミン 86(11), 630-635, 2012-11-25
… Because the use of the classic triad of WE may overlook a mild form of WE that can be detected as inactive WE pathology, Caine and colleagues have proposed the clinical criteria for diagnosis of WE in chronic alcoholics based on the clinical-neuropathological correction. …
NAID 110009554187