In 2000, Powsner et al 1 reported the results of an open-book examination that analyzed the comprehension of written surgical pathology reports by clinicians. They found that surgeons misunderstood reports 30% of the time, and that many discordant interpretations involved major findings. Although little empirical literature had existed on the subject, the results were not entirely unexpected given past problems in communicating the results of cervical cytology and other types of diagnostic biopsies. [2][3][4] Multiple factors likely contribute to this communication gap, including the diverse backgrounds that many clinicians have in surgical pathology. The use of ambiguous terminology may also lead to miscommunication in pathology reports. We receive requests from surgeons to clarify pathology reports that were produced elsewhere because the diagnosis ocular surface squamous neoplasia (OSSN) leaves them confused. Most queries revolve around whether OSSN refers to in situ disease or squamous cell carcinoma, questions that we are unable to answer in any given case without reviewing the slides directly. We take the position that the diagnosis of OSSN serves no purpose in routine surgical pathology, and can result in mismanagement when the distinction of premalignant squamous epithelial dysplasia (including carcinoma in situ) from squamous cell carcinoma is considered clinically relevant.The phrase OSSN was coined by Lee and Hirst 5 in 1995 to describe the continuum of mild epithelial dysplasia to squamous cell carcinoma. In clinical studies of OSSN, lesions that fall along this continuum of severity are moderately positively correlated with important clinical outcomes (eg, rates of recurrence, regional metastasis, and so on), but the associations have not been consistently demonstrable. [5][6][7] This lack of consistency may be due to the fact that biopsy interferes with the natural history of the disease process. This model of neoplastic progression, however, is biologically plausible and conveys sufficiently well the multistep process of cancer development. As a pedagogical tool OSSN can be useful, but the term has no role in diagnostic pathology.According to current usage, OSSN can refer to premalignant disease, to squamous cell carcinoma, or to both conditions. It does not provide clinicians with as much information that would be available to them through traditional vocabulary that subdivides epithelial dysplasia by severity, and identifies cancer, with its potential to metastasize, as the distinct entity of squamous cell carcinoma. When OSSN is reported along with other overlapping (and traditional) histopathologic diagnoses, it may have less elucidating effects than anticipated. When studied in a standardized manner, the addition of histological descriptions to general pathology reports appear to diminish the comprehension of surgeons rather than improve it. 1 The American Joint Committee on Cancer (AJCC) Cancer Staging Manual, seventh edition, recognizes squamous cell carcinoma of the conjunctiva and two his...

w w w When oak wood is heated in an atmosphere of steam at atmospheric pressure, partial pyrolysis commences below 180' C. A t 240' C. the modified wood retains its crushing strength and shows smaller volume changes than the original wood when its moisture content is varied. A t that temperature the pentosans have been almost completely decomposed, but two thirds of the cellulose remains and the lignin shows an apparent increase. Three quarters of the total acid and half of the furfural, but no methanol, appear in the condensate. The temperature range of 940-260' C. 0 ACCURATE studies have been made of the pyrolysis of wood at temperatures below those necessary for the formation of charcoal. This paper presents the results N of small-scale experiments in this field. In 1850 Violette (4) heated small pieces of alder wood in an atmosphere of steam to various temperatures and found that 280' C.was necessary to obtain a residue which resembled charcoal. This temperature was confirmed by Chorley and Ramsey(2) and Klason (S), who also showed that a pronounced exothermic reaction took place when wood was heated in absence of air to about 280' C. Klason's results indicated that there was little decomposition of wood by heat at temperatures below 250' C., but in his experiments the temperature was raised rather rapidly. Experiments have also been made on the effect of temperature up to 150' C. in connection with the kiln drying of wood. The wood becomes stiffer and more brittle, but there is no evidence of destructive distillation.There is lack of information on the behavior of wood when heated in the absence of air at temperatures between 200' and 275' C. Pyrolysis of O a kThe exothermal reaction was reco nized to be so great that special precautions would be requiref to dissipate the heat and keep the temperature uniform. Therefore, heating should be slow, and heat should be applied mainly through a vapor; steam was chosen. It acts partly as an inert gas but also as a reactive agent. The wood was heated in a steel retort set in an electrically heated jacket. Steam a t atmospheric pressure was passed through a pipe in the jacket space and so was superheated when it entered the retort. All runs were made at atmospheric pressure. Two thermocouples were used within the retwt; one was difference amounted to 10". The temperature of the thermocou le within the wood is reported as the temperature of the run in tIese tests. After the desired temperature was reached, it was not allowed to vary over 5" during the run. The one exception is run 14 when the temperature was purposely raised to 400" C. as the run rogressed.Kiln-Zried red oak was the wood tested. In order to measure volume changes during heating, blocks approximately 1 X 1 X 4 inches in size were used. The nine blocks comprising the change were dried at 105' C., cooled, weighed and measured, and placed is critical in spite of control of exothermic reactions. A t 260' C. the pyrolyzed wood has a decidedly lower crushing strength and commences to show charring. The cellul...

HistoryA 26-year-old white man presented with a 4-day history of a scotoma in the left eye only. He characterized the visual field defect as greenish and fixed in a superotemporal, paracentral location. The visual change was sudden in onset and was not associated with other ocular complaints or headache. Past ocular history was remarkable only for a diagnosis of herpes simplex keratitis in the involved eye. One episode had occurred 13 years before. It was treated with trifluridine and was not complicated by scarring or recurrence. Past medical history was unremarkable. Social history was negative for antecedent travel, illicit drugs, or trauma, but was positive for cat exposure. Review of systems was negative. ExaminationVisual acuity was 20/20 in each eye, with intraocular pressures of 15 mm Hg in the right eye and 16 mm Hg in the left eye. Pupils were regular, round, and reactive. A relative afferent pupillary defect was present in the left eye. Extraocular movements were full in both eyes. The patient endorsed temporal visual field loss in the left eye on confrontation. Slit-lamp examination of the anterior segment was unremarkable.