Department of Pathological Anatomy
An integrated work of pedagogical, diagnostic and scientific research activites is practiced in the Clinic of Pathological Anatomy of the Lithuanian University of Health Sciences.
The principal goals of the practice in the Clinic of Pathological Anatomy are:
1.To perform high quality pathology studies that enable to provide one with scientifically-based level of the modern knowledge and technologies with a purpose to reflect university education and its qualification, as well as to develop an overall-educated, ethically responsible and creative personality.
2.To perform the pathological researches of the highest scientific level and to prepare the scientists.
3.To improve the quality of pathological diagnostic services, successfully applying modern technologies and performing the integrated activities of pathological practice.
When the Lithuania University was established on the 16th of February in 1922, the Council of Medicine Faculty, in accordance with the statute approved by Seimas on the 22th of April in 1922, appointed Emilis Vinteleris to establish the Department of the Common Pathology and Pathological Anatomy, and to conduct its activities as a Head of the Department on the 30th of June in 1922. Emilis Vinteleris arrived to Kaunas on the 29th of January in 1923 and started the lectures. On the 18th of September in 1922 the Council of Medicine Faculty appointed prof. Leonas Gogelis as a temporary replacement for the confirmed Head of the Department (until Emilis Vinteleris arrived) to conduct the activities of the Department and to lecture for the students. Janina Mackevičaitė (PhD) was appointed as a senior assistant and Kazys Oželis became the prosector at the time. The Department of Common Pathology and Pathological Anatomy was established in the War Hospital, and in 1923‘s spring this Department was transfered to the 2nd Houses of Lithuanian University (the University of Vytautas Magnus from 1930 06 07). The basis of both academic studies and pathologic diagnostics as well as a museum of macropreparations was developed intensively through the early years of the Department‘s activity. Janina Mackevičaitė – Lašienė translated Herxheimer‘s textbook of the Common Pathology Basics, and it was published in 1925 as the second publication of Medicine Faculty. The Department was transfered to a newly-built Houses of the Medicine Faculty in Mickevičius Street in December, 1932. The academical studies were performed as well as surgical and biopsy material were examined in this building, whereas most of the autopsies were performed in the Hospital of the Red Cross Community.
When the new University Clinics were built in 1939, the Department of Common Pathology and Pathological Anatomy was established in a separate building (present building of the Clinic). Senior professor Janina Mackevičaitė – Lašienė was appointed as a Head of the Pathological Anatomy Department of Kaunas University (the name of the University of Vytautas Magnus at the time in 1940 08 24) on the 12th of February in 1941, when professor Emilis Vinteleris expressed his intentions to migrate to Germany. Associate professor Antanas Starkus (PhD) was appointed as a Head of the Department (the University of Vytautas Magnus regained its earlier name on the 1st of July in 1941 by the Temporary Goverment of Lithuania) on the 9th of August in 1941, but on the 16th of March in 1943 he was transfered to the Stutthof‘s Concentracion Camp. The pedagogical activities as well as pathologic diagnostics were actively performed in 1944 – 1965, when professor Janina Lašienė was the Head of the Department. Moreover, the Service of Lithuanian Pathology was developed, and the Scientific Society of Lithuanian Anatomical Pathologists (present day – pathologists) was established. Therefore, the Department became a central establishment for the pathologists‘ training. Professor Janina Lašienė was particulary interested in the endocrinology field of scientific researches and developed the functional morphology of endocrine glands.
Professor Jūratė Jankevičiūtė (the Head of the Department in 1965 – 1976) carried out the scientific researches in cardiac pathology, and the first lithuanian textbook of Pathological Anatomy was published in 1973.
Professor Elena Stalioraitytė was appointed as a new Head of the Department in 1976. Together with professor Janina Lašienė she analysed the problems of endocrinology. The monography „Endocrine glands of the newborns“ written by professors E. Stalioraitytė and J. Lašienė was evaluated with the Lithuanian National Award. More attention was focused for the perfection of the pedagogical process by applying the elements of problemic studies. Many textbooks were published, including the new publication of the Pathological Anatomy textbook (1986), and the scientific researches of sudden cardiac death were performed actively during this period of time.
The Department of Pathological Anatomy was joined with the Department of Histology and Embryology in 1984 – 1988, whereas in 1988 – 1992 it was in a coalition with the Department of Forensic Medicine (Head of the Department was professor Jonas Nainys in 1988 – 1989 and professor Romualdas Gailys in 1989 – 1992).
The present Clinic of Pathological Anatomy was established in 1992, when the Department was joined with the clinic and the cytological service. Professor Kazys Daukša was appointed as a new Head of the Clinic. Professor Romualdas Gailys was the Head of the Clinic in 2003 – 2009.
The old books of registrated autopsies and biopsies examined, the most important manuscripts, documents of various pathology studies and practice, the copies of all the textbooks and manuals as well as pieces of old equipment are kept in the Department from 1922 and can be seen in the exposition.
Pathological anatomy is a discipline that combines the fundamental sciences and clinical practice. The information that is aquired studying the morphological changes of the organs, tissues and cells induced by human pathological processes and diseases serves as a basic knowoledge for the further development of the essential diagnostic and treatment skills. The general (associated with pathological processes) and systemic, nozologic (associated with the diseases), sections of pathological anatomy are studied.
The students of Medicine programme aquire the basic knowledge of pathological anatomy in the second and the third course, when studying the integrated modules of problemic studies: the basics of the preclinical studies, the reproductive health, the basics of neurosciences, the immune response and infection, the respiration and circulation, the metabolism and homeostasis. The Clinic of Pathological Anatomy conduct the studies of the Immune response section of the Immune response and Infection module.
The students of Odontology programme gain the necessary knowledge of the pathology and the consequence – outcome link between pathological processes in the third course with a purpose to comprehend the morphological basis, the development mechanism and the clinical importance of the pathological processes and diseases.
The students of both Medical – Veterinary Genetics and Medical – Veterinary Biochemistry programmes analyse the morphological basis of pathological processes and the molecular mechanisms related to the development of these processes as well as the clinical importance of these pathological changes in the organism. The basic skills of the morphological and molecular diagnostics are aquired during the studies of Pathological Anatomy.
The students of Oral Hygiene (the 2nd course), Nursery and Obstetrics (the 1st course), Physiotherapy and Ergotherapy (the 2nd course) programmes study the Pathology subject combined of Pathological Anatomy and Patholocial Physiology aquiring the knowledge of the basic pathological processes as well as the morphological basis and development mechanisms of particular diseases.
A more detail approach of the pathological diagnostics is granted in the 6th course when students study clinical pathology and forensic medicine.
A modern auditorium of Janina Lašienė functions as a compatible accommodation for lectures, seminars and tutorials in the totally renovated Study Department in the Clinic of Pathological Anatomy. The classes of practical works are provided with visual – consultation microscopic systems constructed of optic bridges, digital cameras with high resolution characteristics and monitors of 60‘ diagonal parameter as well as binocular microscopes for individual or group studies. The server system is installed for the virtual studies of histological slides. The basic skills of visual analysis are being developed by using Media Cybernetics ImagePro software.
There is a museum of more than 2000 macroscopic preparations in the Clinic of Pathological Anatomy, and the collections of histological slides with routine staining and additional specific histochemical, immunohistochemical, and in situ hybridization reactions are formed. As a result, the deeper comprehension of pathological processes and structural changes of the diseases is achieved in addition to a better understanding of the possibilities of modern pathology diagnostics.
Traditional lectures, studies of macroscopic preparations, histological slides, electronograms, observations of autopsies performances and biopsy material extraction as well as modern technologies of virtual histopathology (telepathology) are combined in the Clinic of Pathological Anatomy. Virtual histopathology (telepathology) is a modern study methodology when microimages of the histological slides related to a particular study topic are demonstrated throughout all the area of specimen cut in real time. The maximum resolution of these microscopic images are the same as in highest power magnification of routine optic microscopy in order to assure autonomous, easy available pathology studies as an alternative for the studies of routine histological slides.
Virtual histopathology http://www.pathonet.lt/moodle/course/category.php?id=44 is also applicable for the tablet personal computers. The descriptions of all histological slides and practical exercises are presented, as well. Students have a possibility to save any image at any magnification according to the individual needs of the study process.
Several elements of problemic studies have been already applied in pathological anatomy studies for approximately three decades when solving the designed morphological diagnostic tasks composed of different collections of macropreparations, histological slides and electronograms. A special consideration of study process is appointed for the autonomous practice. Therefore, all the manuals of practical works have been updated.
All the study material, including interactive textbook „Fundamental Pathology“, the Atlas of Histopathology (both lithuanian and english), the manuals of practical works are digitalized and is available for the students of all study programmes: http://www.pathonet.lt/moodle/.
The studies of pathology residency (4 years) are organized in the Clinic of Pathological Anatomy as well as the studies of other residency programmes that are related to pathological anatomy.
The professors lecture in elective studies, conduct the scientific works for the students, and participate in the doctoral studies. The postgraduate studies for the pathologists are also available.
The professors develop their educational skills using the experience of foreign universities.
The principal tendencies of Scientific Activities
The pathologists – professors of the Pathological Anatomy Clinic participate in executing integrated researches of disease diagnostics, treatment and prognosis (modern pathology diagnostics is an important element of these studies) according to their particular field of specimens analysed, including cerebral neoplasia, neoplastic and non-neoplastic morphological changes of lungs, breast, cervic, gastrointestinal tract, liver, skin and other systems in the organism, by applying modern diagnostic methods of pathology (molecular and gene expression in a protein level). Visual analysis methods are becoming more popular in clinical practice of diagnostics.
The Head of the Biopsy Sector is Darius Pranys, tel. +370 37 32 64 32, e-mail: email@example.com.
The Head of the Cytology Sector is Vestina Martinkutė, tel. +370 37 32 67 18, e-mail: firstname.lastname@example.org.
The Head of the Autopsy Sector is Dainius Jaunčiauskas, tel. +370 37 32 64 05, e-mail: email@example.com.
More than 35 000 specimens of surgical and biopsy material and about 60 000 cytological specimens are analysed in addition to more than 100 autopsy examinations are performed in the Clinic of Pathological Anatomy. The specimens of surgical and biopsy material not only from the Hospital of Lithuanian University of Health Sciences, but also from the other establishments of Health Care system are examined, as well.
Modern technologies of pathological diagnostics are applied in the Clinic‘s routine practice with a purpose to fit the increasing quality requirements of both diagnostic tests and treatment. All the equipment of the Clinic correspond to the present worldwide standarts. The application of both routine histological and specific histochemical staining is used in routine diagnostical practice in addition to an increased use of the immunohistochemical reactions (immunohistochemal reactions with over 100 immunomarkers are performed by automated Roche Ventana processors). There is a progressive increase of the molecular reactions‘ application that are valuable for the present diagnosis identification and for desicions associated with the individual treatment.
Automated tissue preparation for the further examination (pre-analytic stage), the database of pathological patient‘s specimen examination developed by the employees of the Clinic (in lithuanian language) which combines the stages of laboratory work (tissue preparation for further examination) and diagnosis identification with an adequate conclusion (by using macroscopic, histological etc. studies) are the key elements for the assurance of the modern quality standarts of pathological examinations that are applied in routine practice of the Clinic. The quality control system is established, as well.
Pathologists observe structural changes of the tissues by using modern optic microscopes combined with recording equipment.
More attention is focused to the prevention programmes of colorectal, cervical, breast and prostate cancer.
All the histological specimens are stored according to the standarts of pathological examination (over 10 years), therefore all of them are available for a re-evaluation or additional examination.
A great attention is focused on the post-graduate studies of the pathologists: the daily discussion of patients‘ pathological specimens and plans for the further analysis with a purpose to establish a precise pathological diagnosis are conducted. Furthermore, doctors participate and present their cases in various events organised by the professional societies in Lithuania and other countries of Europe.
Moreover, daily meetings with clinicians of other Kaunas Clinics (Surgery, Gastroenterology, Dermatovenerology etc.) are organised where individual, more sophisticated cases of patients are discussed by using multi-binocular microscope and comparing the data of pathological examination and other visual diagnostic methods like common and digital dermatoscopy, siascopy, ultrasound, radionuclidic diagnostics, computerized tomography, magnetic resonanse imaging etc.
Co-workers of the Clinic actively participate in the development of the legal basis that regulate the activities of the Lithuanian Pathology service and the quality of the pathological diagnostics.