Over the past decade, computed tomographic (CT) urography has emerged as the primary imaging modality for evaluating the urinary tract in various clinical settings, including the initial workup of hematuria. With the widespread implementation of CT urography, it is critical for radiologists to understand normal ureteral anatomy and the varied appearance of pathologic ureteral conditions at CT urography. Pathologic findings at CT urography include congenital abnormalities, filling defects, dilatation, narrowing, and deviations in course. These abnormalities are reviewed, along with the indications for CT urography, current imaging protocols with specific techniques for optimal evaluation of the ureter, and dose reduction strategies.

Recognition of this rare entity is important, particularly to avoid the pitfall of misdiagnosing metastatic disease.

Cell adhesion molecule 1 (CADM1) is a member of the immunoglobulin cell adhesion molecule family. Recently, we identified CADM1 to be a novel risk factor for venous thrombosis in a large, protein C deficient, thrombophilic family and showed, for the first time, the expression of CADM1 in endothelial cells (Hasstedt et al. in Blood 114:3084-3091, 2009). To further investigate its role in venous thrombosis, as well as other vasculopathies, we undertook a systematic confocal microscopic investigation for the presence of CADM1 in the vasculature of 28 different human tissues. Paraffin embedded tissue sections were dual immunostained with an antibody against CADM1, together with an antibody against either von Willebrand factor (to identify endothelial cells), or α-smooth muscle actin (to identify smooth muscle cells). The results showed that CADM1 was ubiquitously present in endothelial cells and smooth muscle cells in the vasculature from all 28 tissues, though its representation in the various classes of vessels was tissue dependent.

Context.— Despite the importance of accurate death statistics for epidemiologic studies and public health initiatives, there remains a high frequency of errors in death certification. This deficiency can be addressed by the hospital autopsy service. Objectives.— To improve the quality and accuracy of death certificates issued in the hospital and improve resident and clinician education by initiating a death certificate review process, performed by pathology residents while on their hospital autopsy rotation. Design.— The resident reviewed all death certificates issued in the hospital daily through the state electronic death certificate filing system, and correlated with the decedent's medical record. When errors were found, they filed an amended death certificate with the state. If applicable, the Office of the Medical Examiner was contacted to investigate. The original certifying physician was then contacted via email with an explanation for the amendment. Results.— In 12 months, 590 death certificates were issued by the hospital. Eighty-eight of 590 (15%) were amended. Of those 88 amended, 41 (47%) were missing an underlying cause of death, 7 (8%) had an inaccurate cause of death, 41 (47%) failed to include relevant contributory causes of death, and 17 (19%) had major typographic errors. Of 88, 24 (27%) fell under the Office of the Medical Examiner's jurisdiction and were reported with a subsequent change in the manner of death in 23 of 88 cases (26%). Conclusions.— Death certificates review by the autopsy service improves the accuracy of death certification, impacts resident and clinician education, and serves as quality assurance for both the hospital and the state.

Introduction Medical examiners/coroners serve various functions beyond the medicolegal framework, including making contributions to public safety and health. In order to effectively fulfill this role, it is essential to ensure accurate certification of each death. Materials and Methods In Vermont, the Department of Health, Vital Records Division has developed a death certificate surveillance program in which all registered deaths are reviewed by the Office of the Chief Medical Examiner (OCME). A death certificate is fagged by the OCME for further investigation when cause and manner of death statements are incomplete, erroneous, or suggest the possibility of an unnatural death. If necessary, after review, death certificates are amended. Death Certificate Review (DCR) cases between 2008 and 2011 were retrieved from the OCME database. Data were evaluated for amendments of cause and manner of death. Results The OCME reviewed all death certificates and further investigated 4.4% and amended 3.3% of all death certificates in Vermont between the years 2008–2011. Eighty-eight percent of the amended DCRs were for cause of death statements and 10% resulted in change of manner. For the latter, change from natural to accident was most frequent. Conclusions Death certificates are a major source of epidemiologic data. Ensuring complete and accurate death certification through death certificate surveillance is a small but significant contribution of the OCME to public health.