Mechanical thrombectomy for pediatric stroke arising from an atrial myxoma: case report.

Children experiencing severe neurological deficit due to acute ischemic stroke may benefit from endovascular intervention. The authors describe the use of mechanical thrombectomy in the treatment of embolic occlusion secondary to an atrial myxoma in a pediatric patient. This case involved an 11-year-old boy with a history notable for Raynaud syndrome and a distal extremity rash who presented to the emergency department with dense hemiparesis secondary to thromboembolic occlusion of the M1 segment of the middle cerebral artery.

The pathology milestones and the next accreditation system.

Context: In the late 1990s, the Accreditation Council for Graduate Medical Education developed the Outcomes Project and the 6 general competencies with the intent to improve the outcome of graduate medical education in the United States. The competencies were used as the basis for developing learning goals and objectives and tools to evaluate residents' performance. By the mid-2000s the stakeholders in resident education and the general public felt that the Outcomes Project had fallen short of expectations.

Histopathologic characterization of chronic radiofrequency ablation lesions for pulmonary vein isolation.

Objectives: This study describes the histopathologic and electrophysiological findings in patients with recurrence of atrial fibrillation (AF) after pulmonary vein (PV) isolation who underwent a subsequent surgical maze procedure.

Background: The recovery of PV conduction is commonly responsible for recurrence of AF after catheter-based PV isolation.

Methods: Twelve patients with recurrent AF after acutely successful catheter-based antral PV isolation underwent a surgical maze procedure.

Senior pathology resident in-service examination scores correlate with outcomes of the American Board of Pathology certifying examinations.

The Resident In-Service Examination (RISE) addresses 1 area of the Accreditation Council for Graduate Medical Education Outcome Project; RISE results demonstrate progressive attainment of pathology knowledge during training. We compared RISE scores with primary pathology board certification success for residents graduating in 2008 and 2009. Overall RISE and nearly all sectional scores in anatomic and clinical pathology were significantly higher for residents passing all certifying examinations at the first attempt vs residents who failed any examination.

CD44(+)/CD24(-/low) cancer stem/progenitor cells are more abundant in triple-negative invasive breast carcinoma phenotype and are associated with poor outcome.

Women classified as having triple-negative tumors have a poor prognosis. The importance of CD44(+)/CD24(-/low) (stem/progenitor cell-phenotype) in breast cancer patients has also been appreciated. However, correlation between triple negativity and CD44(+)/CD24(-/low) with tumor recurrence remains elusive.

Tumor escape and progression of HER-2/neu negative breast cancer under immune pressure.

Background: Emerging data from pre-clinical and clinical studies suggest that HER-2/neu-specific T cell responses could induce HER-2/neu antigen loss in the tumor cells. These data suggest that patients with HER-2/neu negative breast cancer might have had HER-2/neu positive premalignant lesions in the past that progressed to HER-2/neu negative breast cancer under HER-2/neu-specific immune pressure.

Methods: We conducted a pilot study in patients with HER-2/neu positive and HER-2/neu negative breast cancers as well as a patient with ductal carcinoma in situ (DCIS).

Certification and maintenance of certification: updates from the American Board of Pathology.

The American Board of Pathology continues to update the certification process to ensure that all candidates have appropriate training and credentials and meet the competency requirements of the Accreditation Council for Graduate Medical Education. The maintenance of certification process, instituted in 2006, has gone through 2 reporting cycles; and the American Board of Pathology is preparing for administration of the first maintenance of certification examination in 2014. This article updates the pathology community on these changes.

Adequacy of pathology resident training for employment: a survey report from the Future of Pathology Task Group.

Context: The recent change in accreditation requirements for anatomic pathology and clinical pathology residency training from 5 to 4 years and the rapid advances in technologies for pathology services have sparked a renewed debate over the adequacy of pathology residency training. In particular, perceived deficiencies in training have been declared from a variety of sources, both in the form of recent editorial opinions and from surveys of community hospital pathologist employers in 1998, 2003, and 2005 by Dr Richard Horowitz.

Objective: To obtain more comprehensive data on the perceptions of strengths and weaknesses in pathology residency training.

Localized malignant mesothelioma.

Localized malignant mesotheliomas are uncommon sharply circumscribed tumors of the serosal membranes with the microscopic appearance of diffuse malignant mesothelioma but without any evidence of diffuse spread. Little is known about their behavior. We report 23 new cases.

Electrifying a medical school course: a case study.

Background: At Virginia Commonwealth University School of Medicine, the Dean charged the curriculum office to "electrify the curriculum." An instructional development team chose a 2nd-year course to serve as a model e-course and to provide evaluation data for a 2-year study.

Description: The instructional development process used instructional and Web design principles.

Focal asymmetric densities seen at mammography: US and pathologic correlation.

The American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) defines four different types of asymmetric breast findings: asymmetric breast tissue, densities seen in one projection, architectural distortion, and focal asymmetric densities. These lesions are frequently encountered at screening and diagnostic mammography and are significant because they may indicate a neoplasm, especially if an associated palpable mass is present. Once these lesions are detected at standard mammography, supplementary breast imaging with additional mammographic views and ultrasonography (US) can be a key aspect of work-up.