When I'm making that diagnosis, I'm committing that child to losing at least some rectum, because if I firmly state that this patient has Hirschprung disease and saying consistent with Hirschprung disease is the same thing in my mind.
When I'm making that diagnosis, I'm committing that child to losing at least some rectum, because if I firmly state that this patient has Hirschprung disease and saying consistent with Hirschprung disease is the same thing in my mind.
When I'm making that diagnosis, I'm committing that child to losing at least some rectum, because if I firmly state that this patient has Hirschprung disease and saying consistent with Hirschprung disease is the same thing in my mind.
When I'm making that diagnosis, I'm committing that child to losing at least some rectum, because if I firmly state that this patient has Hirschprung disease and saying consistent with Hirschprung disease is the same thing in my mind.
clinicalWhen diagnosing Hirschsprung disease on suction rectal biopsy, the pathologist is committing that child to losing at least some rectum.↗
▶Ep 23 · 17:26
clinicalWhen diagnosing Hirschsprung disease on suction rectal biopsy, the pathologist is committing that child to losing at least some rectum.↗
▶Ep 23 · 17:26
quoteWhen I'm making that diagnosis, I'm committing that child to losing at least some rectum, because if I firmly state that this patient has Hirschprung disease and saying consistent with Hirschprung disease is the same thing in my mind.↗
▶Ep 23 · 17:26
quoteWhen I'm making that diagnosis, I'm committing that child to losing at least some rectum, because if I firmly state that this patient has Hirschprung disease and saying consistent with Hirschprung disease is the same thing in my mind.↗
▶Ep 23 · 18:00
clinicalIf a pathologist diagnoses Hirschsprung disease on suction biopsy and the surgeon finds ganglion cells at the peritoneal reflection, the patient still has short segment disease.↗
▶Ep 23 · 18:00
clinicalIf a pathologist diagnoses Hirschsprung disease on suction biopsy and the surgeon finds ganglion cells at the peritoneal reflection, the patient still has short segment disease.↗
▶Ep 23 · 18:35
opinionA pathologist must be very confident when diagnosing Hirschsprung disease on biopsy, recognizing the medicolegal implications if the diagnosis is wrong.↗
▶Ep 23 · 18:35
opinionA pathologist must be very confident when diagnosing Hirschsprung disease on biopsy, recognizing the medicolegal implications if the diagnosis is wrong.↗
▶Ep 23 · 18:35
quoteI wanna be very confident when I'm diagnosing Hirschberg disease on that biopsy and recognizing that if I blow it, I'm probably gonna get sued.↗
▶Ep 23 · 18:35
quoteI wanna be very confident when I'm diagnosing Hirschberg disease on that biopsy and recognizing that if I blow it, I'm probably gonna get sued.↗
▶Ep 23 · 19:05
quoteIf there's any equivocation or iffiness to the biopsy, that's where this rapport with the surgeon becomes so critical.↗
▶Ep 23 · 19:05
quoteIf there's any equivocation or iffiness to the biopsy, that's where this rapport with the surgeon becomes so critical.↗
▶Ep 23 · 19:05
opinionIf there is any equivocation about the biopsy, clear communication with the surgeon is critical to discuss whether material is suboptimal or methods are inadequate.↗
▶Ep 23 · 19:05
opinionIf there is any equivocation about the biopsy, clear communication with the surgeon is critical to discuss whether material is suboptimal or methods are inadequate.↗
▶Ep 23 · 20:35
quoteA lot of it comes back to experience and the panel's already made that point that, you know, a, an experienced pathologist can do things like, I think, recognize immature gangon cells probably even at 28 weeks.↗
▶Ep 23 · 20:35
clinicalAn experienced pathologist can recognize immature ganglion cells, probably even at 28 weeks, though this is rarely requested in suction biopsies.↗
▶Ep 23 · 20:35
clinicalAn experienced pathologist can recognize immature ganglion cells, probably even at 28 weeks, though this is rarely requested in suction biopsies.↗
▶Ep 23 · 20:35
quoteA lot of it comes back to experience and the panel's already made that point that, you know, a, an experienced pathologist can do things like, I think, recognize immature gangon cells probably even at 28 weeks.↗
▶Ep 23 · 20:52
clinicalAn experienced pathologist knows how to apply and interpret ancillary studies and, most importantly, knows when material is suboptimal.↗
▶Ep 23 · 20:52
clinicalAn experienced pathologist knows how to apply and interpret ancillary studies and, most importantly, knows when material is suboptimal.↗
▶Ep 23 · 25:55
clinicalAncillary studies are extremely helpful when there are conflicting or ambiguous results or suboptimal specimen adequacy.↗
▶Ep 23 · 25:55
clinicalAncillary studies are extremely helpful when there are conflicting or ambiguous results or suboptimal specimen adequacy.↗
▶Ep 23 · 26:33
clinicalIf a patient has no ganglion cells and adequate submucosa but no hypertrophic nerves, a convincing abnormality in calretinin immunoreactivity or acetylcholinesterase staining can be enough to make the diagnosis of Hirschsprung disease.↗
▶Ep 23 · 26:33
clinicalIf a patient has no ganglion cells and adequate submucosa but no hypertrophic nerves, a convincing abnormality in calretinin immunoreactivity or acetylcholinesterase staining can be enough to make the diagnosis of Hirschsprung disease.↗
▶Ep 23 · 27:10
clinicalExperienced pathologists develop a gestalt for recognizing too many, too big nerves rather than relying solely on measurements.↗
▶Ep 23 · 27:10
clinicalExperienced pathologists develop a gestalt for recognizing too many, too big nerves rather than relying solely on measurements.↗
▶Ep 23 · 27:19
clinicalThe 40-micron rule (nerves should not exceed 40 microns in diameter in distal rectum of infants under 6 months) is generally true but has rare exceptions, and does not hold in older children.↗
▶Ep 23 · 27:19
clinicalThe 40-micron rule (nerves should not exceed 40 microns in diameter in distal rectum of infants under 6 months) is generally true but has rare exceptions, and does not hold in older children.↗
▶Ep 23 · 27:54
clinicalThe pattern of nerve hypertrophy involves a shift in caliber of all nerves, with more intermediate, moderately enlarged, and markedly enlarged nerves in greater concentration than normal.↗
▶Ep 23 · 27:54
clinicalThe pattern of nerve hypertrophy involves a shift in caliber of all nerves, with more intermediate, moderately enlarged, and markedly enlarged nerves in greater concentration than normal.↗
▶Ep 23 · 40:49
quoteI have to say, having done some of what Doctor Pena asked for in terms of topographical mapping of patients with short segment Hirschprung disease, I am not as convinced as I once was that IND has been put to death yet.↗
▶Ep 23 · 40:49
opinionDr. Kapoor remains open-minded about whether there is an age-related change in the density of giant ganglia in the submucosa that is shifted in Hirschsprung patients.↗
▶Ep 23 · 40:49
opinionDr. Kapoor remains open-minded about whether there is an age-related change in the density of giant ganglia in the submucosa that is shifted in Hirschsprung patients.↗
▶Ep 23 · 40:49
quoteI have to say, having done some of what Doctor Pena asked for in terms of topographical mapping of patients with short segment Hirschprung disease, I am not as convinced as I once was that IND has been put to death yet.↗
▶Ep 23 · 41:33
opinionStudying IND properly requires many patients, patience in counting ganglion cells, and huge effort to correlate findings with outcome while controlling for other variables.↗
▶Ep 23 · 41:33
opinionStudying IND properly requires many patients, patience in counting ganglion cells, and huge effort to correlate findings with outcome while controlling for other variables.↗
Hirschsprung Disease: Pathology Aspect
▶Ep 43 · 16:36
clinicalWhen making a diagnosis of Hirschsprung disease on suction rectal biopsy, the pathologist is committing that child to losing at least some rectum.↗
▶Ep 43 · 16:42
quoteWhen I'm making that diagnosis, I'm committing that child to losing at least some rectum.↗
▶Ep 43 · 17:10
clinicalIf a suction rectal biopsy confidently shows absent ganglion cells and the surgeon finds ganglion cells at the peritoneal reflection, the patient still has short segment disease and will lose a short length of rectum.↗
▶Ep 43 · 18:15
opinionIf there is any equivocation or iffiness to the biopsy, clear communication with the surgeon is critical, and it may be necessary to rebiopsy or think of other strategies.↗
▶Ep 43 · 19:33
opinionA lot of confident diagnosis comes back to experience: an experienced pathologist can recognize immature ganglion cells, knows how to apply and interpret ancillary studies, and knows when material is suboptimal.↗
▶Ep 43 · 25:05
opinionAncillary studies or ancillary findings are extremely helpful when you have conflicting or ambiguous results or suboptimal adequacy of a specimen.↗
▶Ep 43 · 25:43
clinicalIf a patient has no ganglion cells and adequate submucosa but no hypertrophic nerves, a convincing abnormality in calretinin immunoreactivity or acetylcholinesterase staining can be enough to discount the lack of hypertrophic nerves and make the diagnosis of Hirschsprung disease.↗
▶Ep 43 · 26:20
opinionAn experienced pathologist gets a real feel for a gestalt of what are too many, too big nerves, rather than relying on nerve measurements with calipers.↗
▶Ep 43 · 26:29
clinicalThe 40 micron rule (that in a young infant under 6 months of age, you shouldn't see in the distal rectum nerves greater than 40 microns in diameter) is generally true at that young age, but there are rare exceptions, and in older age kids that rule does not hold.↗
▶Ep 43 · 39:59
opinionDr. Kapoor is not as convinced as he once was that IND has been put to death, and remains open-minded as to whether there is an age-related change in the density of giant ganglia in the submucosa that is shifted in patients with Hirschsprung disease.↗
quoteWhen I'm making that diagnosis, I'm committing that child to losing at least some rectum, because if I firmly state that this patient has Hirschprung disease and saying consistent with Hirschprung disease is the same thing in my mind.↗
▶Ep 9 · 17:26
clinicalWhen diagnosing Hirschsprung disease on suction rectal biopsy, the pathologist is committing that child to losing at least some rectum.↗
▶Ep 9 · 17:26
clinicalWhen diagnosing Hirschsprung disease on suction rectal biopsy, the pathologist is committing that child to losing at least some rectum.↗
▶Ep 9 · 17:26
quoteWhen I'm making that diagnosis, I'm committing that child to losing at least some rectum, because if I firmly state that this patient has Hirschprung disease and saying consistent with Hirschprung disease is the same thing in my mind.↗
▶Ep 9 · 18:00
clinicalIf a pathologist diagnoses Hirschsprung disease on suction biopsy and the surgeon finds ganglion cells at the peritoneal reflection, the patient still has short segment disease.↗
▶Ep 9 · 18:00
clinicalIf a pathologist diagnoses Hirschsprung disease on suction biopsy and the surgeon finds ganglion cells at the peritoneal reflection, the patient still has short segment disease.↗
▶Ep 9 · 18:35
quoteI wanna be very confident when I'm diagnosing Hirschberg disease on that biopsy and recognizing that if I blow it, I'm probably gonna get sued.↗
▶Ep 9 · 18:35
opinionA pathologist must be very confident when diagnosing Hirschsprung disease on biopsy, recognizing the medicolegal implications if the diagnosis is wrong.↗
▶Ep 9 · 18:35
opinionA pathologist must be very confident when diagnosing Hirschsprung disease on biopsy, recognizing the medicolegal implications if the diagnosis is wrong.↗
▶Ep 9 · 18:35
quoteI wanna be very confident when I'm diagnosing Hirschberg disease on that biopsy and recognizing that if I blow it, I'm probably gonna get sued.↗
▶Ep 9 · 19:05
quoteIf there's any equivocation or iffiness to the biopsy, that's where this rapport with the surgeon becomes so critical.↗
▶Ep 9 · 19:05
opinionIf there is any equivocation about the biopsy, clear communication with the surgeon is critical to discuss whether material is suboptimal or methods are inadequate.↗
▶Ep 9 · 19:05
quoteIf there's any equivocation or iffiness to the biopsy, that's where this rapport with the surgeon becomes so critical.↗
▶Ep 9 · 19:05
opinionIf there is any equivocation about the biopsy, clear communication with the surgeon is critical to discuss whether material is suboptimal or methods are inadequate.↗
▶Ep 9 · 20:35
clinicalAn experienced pathologist can recognize immature ganglion cells, probably even at 28 weeks, though this is rarely requested in suction biopsies.↗
▶Ep 9 · 20:35
quoteA lot of it comes back to experience and the panel's already made that point that, you know, a, an experienced pathologist can do things like, I think, recognize immature gangon cells probably even at 28 weeks.↗
▶Ep 9 · 20:35
clinicalAn experienced pathologist can recognize immature ganglion cells, probably even at 28 weeks, though this is rarely requested in suction biopsies.↗
▶Ep 9 · 20:35
quoteA lot of it comes back to experience and the panel's already made that point that, you know, a, an experienced pathologist can do things like, I think, recognize immature gangon cells probably even at 28 weeks.↗
▶Ep 9 · 20:52
clinicalAn experienced pathologist knows how to apply and interpret ancillary studies and, most importantly, knows when material is suboptimal.↗
▶Ep 9 · 20:52
clinicalAn experienced pathologist knows how to apply and interpret ancillary studies and, most importantly, knows when material is suboptimal.↗
▶Ep 9 · 25:55
clinicalAncillary studies are extremely helpful when there are conflicting or ambiguous results or suboptimal specimen adequacy.↗
▶Ep 9 · 25:55
clinicalAncillary studies are extremely helpful when there are conflicting or ambiguous results or suboptimal specimen adequacy.↗
▶Ep 9 · 26:33
clinicalIf a patient has no ganglion cells and adequate submucosa but no hypertrophic nerves, a convincing abnormality in calretinin immunoreactivity or acetylcholinesterase staining can be enough to make the diagnosis of Hirschsprung disease.↗
▶Ep 9 · 26:33
clinicalIf a patient has no ganglion cells and adequate submucosa but no hypertrophic nerves, a convincing abnormality in calretinin immunoreactivity or acetylcholinesterase staining can be enough to make the diagnosis of Hirschsprung disease.↗
▶Ep 9 · 27:10
clinicalExperienced pathologists develop a gestalt for recognizing too many, too big nerves rather than relying solely on measurements.↗
▶Ep 9 · 27:10
clinicalExperienced pathologists develop a gestalt for recognizing too many, too big nerves rather than relying solely on measurements.↗
▶Ep 9 · 27:19
clinicalThe 40-micron rule (nerves should not exceed 40 microns in diameter in distal rectum of infants under 6 months) is generally true but has rare exceptions, and does not hold in older children.↗
▶Ep 9 · 27:19
clinicalThe 40-micron rule (nerves should not exceed 40 microns in diameter in distal rectum of infants under 6 months) is generally true but has rare exceptions, and does not hold in older children.↗
▶Ep 9 · 27:54
clinicalThe pattern of nerve hypertrophy involves a shift in caliber of all nerves, with more intermediate, moderately enlarged, and markedly enlarged nerves in greater concentration than normal.↗
▶Ep 9 · 27:54
clinicalThe pattern of nerve hypertrophy involves a shift in caliber of all nerves, with more intermediate, moderately enlarged, and markedly enlarged nerves in greater concentration than normal.↗
▶Ep 9 · 40:49
quoteI have to say, having done some of what Doctor Pena asked for in terms of topographical mapping of patients with short segment Hirschprung disease, I am not as convinced as I once was that IND has been put to death yet.↗
▶Ep 9 · 40:49
opinionDr. Kapoor remains open-minded about whether there is an age-related change in the density of giant ganglia in the submucosa that is shifted in Hirschsprung patients.↗
▶Ep 9 · 40:49
quoteI have to say, having done some of what Doctor Pena asked for in terms of topographical mapping of patients with short segment Hirschprung disease, I am not as convinced as I once was that IND has been put to death yet.↗
▶Ep 9 · 40:49
opinionDr. Kapoor remains open-minded about whether there is an age-related change in the density of giant ganglia in the submucosa that is shifted in Hirschsprung patients.↗
▶Ep 9 · 41:33
opinionStudying IND properly requires many patients, patience in counting ganglion cells, and huge effort to correlate findings with outcome while controlling for other variables.↗
▶Ep 9 · 41:33
opinionStudying IND properly requires many patients, patience in counting ganglion cells, and huge effort to correlate findings with outcome while controlling for other variables.↗
Hirschsprung Disease: Pathology Aspect
▶Ep 20 · 16:36
clinicalWhen making a diagnosis of Hirschsprung disease on suction rectal biopsy, the pathologist is committing that child to losing at least some rectum.↗
▶Ep 20 · 16:36
clinicalWhen making a diagnosis of Hirschsprung disease on suction rectal biopsy, the pathologist is committing that child to losing at least some rectum.↗
▶Ep 20 · 16:42
quoteWhen I'm making that diagnosis, I'm committing that child to losing at least some rectum.↗
▶Ep 20 · 16:42
quoteWhen I'm making that diagnosis, I'm committing that child to losing at least some rectum.↗
▶Ep 20 · 17:10
clinicalIf a suction rectal biopsy confidently shows absent ganglion cells and the surgeon finds ganglion cells at the peritoneal reflection, the patient still has short segment disease and will lose a short length of rectum.↗
▶Ep 20 · 17:10
clinicalIf a suction rectal biopsy confidently shows absent ganglion cells and the surgeon finds ganglion cells at the peritoneal reflection, the patient still has short segment disease and will lose a short length of rectum.↗
▶Ep 20 · 18:15
opinionIf there is any equivocation or iffiness to the biopsy, clear communication with the surgeon is critical, and it may be necessary to rebiopsy or think of other strategies.↗
▶Ep 20 · 18:15
opinionIf there is any equivocation or iffiness to the biopsy, clear communication with the surgeon is critical, and it may be necessary to rebiopsy or think of other strategies.↗
▶Ep 20 · 19:33
opinionA lot of confident diagnosis comes back to experience: an experienced pathologist can recognize immature ganglion cells, knows how to apply and interpret ancillary studies, and knows when material is suboptimal.↗
▶Ep 20 · 19:33
opinionA lot of confident diagnosis comes back to experience: an experienced pathologist can recognize immature ganglion cells, knows how to apply and interpret ancillary studies, and knows when material is suboptimal.↗
▶Ep 20 · 25:05
opinionAncillary studies or ancillary findings are extremely helpful when you have conflicting or ambiguous results or suboptimal adequacy of a specimen.↗
▶Ep 20 · 25:05
opinionAncillary studies or ancillary findings are extremely helpful when you have conflicting or ambiguous results or suboptimal adequacy of a specimen.↗
▶Ep 20 · 25:43
clinicalIf a patient has no ganglion cells and adequate submucosa but no hypertrophic nerves, a convincing abnormality in calretinin immunoreactivity or acetylcholinesterase staining can be enough to discount the lack of hypertrophic nerves and make the diagnosis of Hirschsprung disease.↗
▶Ep 20 · 25:43
clinicalIf a patient has no ganglion cells and adequate submucosa but no hypertrophic nerves, a convincing abnormality in calretinin immunoreactivity or acetylcholinesterase staining can be enough to discount the lack of hypertrophic nerves and make the diagnosis of Hirschsprung disease.↗
▶Ep 20 · 26:20
opinionAn experienced pathologist gets a real feel for a gestalt of what are too many, too big nerves, rather than relying on nerve measurements with calipers.↗
▶Ep 20 · 26:20
opinionAn experienced pathologist gets a real feel for a gestalt of what are too many, too big nerves, rather than relying on nerve measurements with calipers.↗
▶Ep 20 · 26:29
clinicalThe 40 micron rule (that in a young infant under 6 months of age, you shouldn't see in the distal rectum nerves greater than 40 microns in diameter) is generally true at that young age, but there are rare exceptions, and in older age kids that rule does not hold.↗
▶Ep 20 · 26:29
clinicalThe 40 micron rule (that in a young infant under 6 months of age, you shouldn't see in the distal rectum nerves greater than 40 microns in diameter) is generally true at that young age, but there are rare exceptions, and in older age kids that rule does not hold.↗
▶Ep 20 · 39:59
opinionDr. Kapoor is not as convinced as he once was that IND has been put to death, and remains open-minded as to whether there is an age-related change in the density of giant ganglia in the submucosa that is shifted in patients with Hirschsprung disease.↗
▶Ep 20 · 39:59
opinionDr. Kapoor is not as convinced as he once was that IND has been put to death, and remains open-minded as to whether there is an age-related change in the density of giant ganglia in the submucosa that is shifted in patients with Hirschsprung disease.↗
