Armed Forces Institute of Pathology

Washington, DC, United States

Armed Forces Institute of Pathology

Washington, DC, United States
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Richard M. Evans, MD, Ophthalmologist at Medical Center Ophthalmology Associates, and affiliated with Baptist Medical Center, has been named a 2017 Top Doctor in San Antonio, Texas. Top Doctor Awards is dedicated to selecting and honoring those healthcare practitioners who have demonstrated clinical excellence while delivering the highest standards of patient care. Dr. Richard M. Evans is a highly experienced ophthalmologist, having been in practice for over four decades. His long and successful medical career began in 1971, when he graduated from the University of Texas Medical Branch at Galveston. After an internship at the Malcolm Grow Medical Center and a residency at the University of Texas, Dr. Evans completed a fellowship at the Armed Forces Institute of Pathology. Dr. Evans is certified by the American Board of Ophthalmology, and he diagnoses and treats a wide range of conditions relating to the eye. Conditions treated by him include corneal diseases, glaucoma, diseases of the retina, keratitis, eye cancer, and strabismus. He is especially noted as an expert in refractive ophthalmology and the treatment of cataracts. With his wealth of experience to call upon, Dr. Evans is an ophthalmologist in high demand. He is renowned for his patient centric focus, and says that being a good listener is the most crucial part of his job as it helps him to precisely diagnose and then treat their conditions. His dedication and commitment makes Dr. Richard M. Evans a very worthy winner of a 2017 Top Doctor Award. Top Doctor Awards specializes in recognizing and commemorating the achievements of today’s most influential and respected doctors in medicine. Our selection process considers education, research contributions, patient reviews, and other quality measures to identify top doctors.

Bernard S.A.,Pennsylvania State University | Murphey M.D.,Armed Forces Institute of Pathology | Flemming D.J.,Pennsylvania State University
Radiology | Year: 2010

Purpose: To validate a technique for reproducible measurement of the osteochondroma cartilage cap with computed tomography (CT) and magnetic resonance (MR) imaging and to reevaluate the correlation of the thickness of the cartilage cap with pathologic findings to improve noninvasive differentiation of benign osteochondromas from secondary chondrosarcomas. Materials and Methods: The institutional review board approved the study and waived the need for informed consent. HIPAA compliance was maintained. After validation of the measurement technique, 101 pathologically confirmed osteochondromas were retrospectively reviewed. Patient demographic data, histologic diagnosis, and chondrosarcoma grade were recorded. Two musculoskeletal radiologists used a standardized technique to independently measure the thicknesses of the cartilage caps on CT and MR images; these measurements were compared for interobserver agreement. Agreement between measurements with CT and MR imaging was also evaluated, as were the sensitivity and specificity of both modalities for differentiation of osteochondromas from chondrosarcomas. Results: Evaluated were 67 benign osteochondromas (from 49 male patients and 18 female patients; mean age, 23.4 years) and 34 secondary chondrosarcomas (from 27 male patients and seven female patients; mean age, 33.2 years). On the basis of the proposed measuring technique, there was 88% inter-observer measurement agreement with MR imaging (95% confidence interval [CI]: 80%, 94%) and 93% with CT (95% CI: 84%, 98%). The median difference between measurements of cap thickness at CT and MR imaging was 0 cm (25th and 75th percentiles, -3 mm and 1 mm, respectively). With 2 cm used as a cutoff for distinguishing benign osteochondromas from chondrosarcomas, the sensitivities and specificities were 100% and 98% for MR imaging and 100% and 95% for CT, respectively. Conclusion: The proposed measuring technique allows accurate and reproducible measurement of cartilage cap thickness with both CT and MR imaging. Cap thickness of 2 cm or greater strongly indicated secondary chondrosarcomas. © RSNA, 2010.

Miettinen M.,U.S. National Cancer Institute | Lasota J.,Armed Forces Institute of Pathology
Journal of Surgical Oncology | Year: 2011

Gastrointestinal stromal tumor (GIST), generally driven by oncogenic KIT or PDGFRA mutations, is the most common mesenchymal tumor of the gastrointestinal (GI) tract. GIST is most common in the stomach (60%) and small intestine (30%), but can occur anywhere in the GI-tract and the intra-abdominal soft tissues. GIST can show spindle cell or epithelioid morphology, and mitotic count and tumor size are most important prognostic parameters. GISTs in NF1 patients and children are distinctive clinicopathologic groups. Immunohistochemical testing for KIT and sometimes for DOG1/Ano 1 is essential in confirming the diagnosis. J. Surg. Oncol. 2011; 104:865-873. © 2011 Wiley Periodicals, Inc.

The International Association of HealthCare Professionals is pleased to welcome Anthony O. Roberts, MD, Ophthalmologist, to their prestigious organization with his upcoming publication in The Leading Physicians of the World. He is a highly trained and qualified ophthalmologist with a vast expertise in all facets of his work, especially cataract surgery and laser vision surgery. Dr. Roberts has been in practice for more than 25 years and is currently serving patients at Shady Grove Ophthalmology in Rockville, Maryland, which he established in 1996. Dr. Roberts’ career in medicine began in 1990 when he graduated Cum Laude with his Medical Degree from the University of Maryland School of Medicine. Following his graduation, Dr. Roberts completed his internship at Providence Hospital, before undertaking his Ocular Pathology fellowship at the Armed Forces Institute of Pathology. He then received his specialty training in Ophthalmology at Suny Stony Brook/Nassau County Medical Center and in the Harvard Lancaster program. Dr. Roberts keeps up to date with the latest advances and developments in his field through his professional membership with the American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgery, and is a certified VISX Laser Surgeon. Dr. Roberts has extensive expertise in refractive surgery, having performed over 30,000 refractive procedures, including LASIK eye surgery, PRK surgery, cataract extraction, and refractive lens exchange procedures. Dr. Roberts attributes his success to his bedside manner that makes his patients feel very relaxed, and in his free time, he likes to relax by playing golf, tennis, and traveling. Learn more about Dr. Roberts here: and be sure to read his upcoming publication in The Leading Physicians of the World. is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics.  Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review. features each doctor’s full professional biography highlighting their achievements, experience, patient reviews and areas of expertise.  A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life.  For more information about FindaTopDoc, visit:

Walsh D.S.,U.S. Army | Portaels F.,Institute of Tropical Medicine | Meyers W.M.,Armed Forces Institute of Pathology
Dermatologic Clinics | Year: 2011

Buruli ulcer (BU), caused by the environmental organism Mycobacterium ulcerans and characterized by necrotizing skin and bone lesions, poses important public health issues as the third most common mycobacterial infection in humans. Pathogenesis of M ulcerans is mediated by mycolactone, a necrotizing immunosuppressive toxin. First-line therapy for BU is rifampin plus streptomycin, sometimes with surgery. New insights into the pathogenesis of BU should improve control strategies. © 2011.

Harcke H.T.,Armed Forces Institute of Pathology
Journal of special operations medicine : a peer reviewed journal for SOF medical professionals | Year: 2011

Intraosseous vascular infusion (IO) is a recognized alternative to peripheral intravenous infusion when access is inadequate. The sternum and proximal tibia are the preferred sites. A review of 98 cases at autopsy revealed successful sternal IO placement in 78 cases (80%). Assuming a worst case scenario for placement (pin mark and no tip in bone [17 cases] and tip present and not in the sternum [3 cases]), attempts were unsuccessful in 20 cases (20%). We draw no specific conclusions regarding sternal IO use, but hope that personnel placing these devices and those providing medical training can use the information. 2011.

Khattak S.A.,Armed Forces Institute of Pathology
JPMA. The Journal of the Pakistan Medical Association | Year: 2012

To determine the prevalence of various mutations in beta (beta) thalassaemia and its association with haematological parameters. A descriptive cross sectional study was carried out in the Department of Haematology, Armed Forced Institute of Pathology (AFIP) from February 2009 to January 2010. A total of 515 carriers having beta thalassaemia mutations characterized by Multiplex amplification refractory mutation system (ARMS) were included in the study. Frequencies of different beta thalassaemia mutations were calculated. Mutations were analyzed for their haematological parameters which include total red blood cell count (TRBC), haemoglobin (Hb), mean cell volume (MCV), mean cell haemoglobin (MCH) and red cell distribution width (RDW). Frame shift (Fr) 8-9 was the most common mutation found in 183 (35.5%) of patients followed by intervening sequence 1-5 (IVSI-5) in 126 (24.5%) and Fr 41-42 in 76 (14.8%) while IVSII-1 was the least common mutation found in 1 patient. Fr 8-9 was also the commonest mutation in Punjabis and Pathans. Predominant mutation in other ethnic carriers was IVSI-5. Patients with Fr 8-9 mutation had the lowest mean MCV and MCH of 63.7fl and 19.1pg, of all the mutations. Patients with CAP+1 mutation had mean TRBC, Hb, MCV, MCH and RDW of 5.5 x 1012/L, 13.5g/dl, 78.0fl, 24.7pg and 41.9fl respectively. Fr 8-9 is the most common beta thalassaemia mutation with lowest red cell indices while CAP+1 mutation can present with normal red cell values therefore, a potential carrier should be screened for CAP+1 mutation by DNA analysis.

Cunningham R.E.,Armed Forces Institute of Pathology
Methods in molecular biology (Clifton, N.J.) | Year: 2010

This chapter provides an introduction to the use of fluorescent probes in flow cytometry. Sample preparation for the use of surface labeling with antibodies as well as for the use of nucleic acid probes is discussed. The utility of cell sorting is also discussed.

Bratthauer G.L.,Armed Forces Institute of Pathology
Methods in molecular biology (Clifton, N.J.) | Year: 2010

Immunoenzyme methods can be enhanced by the use of the high affinity molecules, avidin and biotin. The binding of avidin to biotin is almost irreversible. By labeling a detection enzyme such as horseradish peroxidase with biotin, and a secondary antibody (reactive against the antigen detecting primary antibody) with biotin as well, these two compounds can then be linked irreversibly with avidin. For this process, the biotinylated enzyme is complexed with avidin in solution and this avidin-biotin complex (ABC) is then introduced to the biotinylated secondary antibody, where it binds to primary antibody-antigen sites. Also, enzyme-labeled avidin molecules can be used to bind biotinylated secondary antibodies with greater resolution. Finally, biotinylated tyramide used in conjunction with peroxidase precipitates even greater amounts of biotin molecules for detection by enzyme-labeled avidin molecules.

Satti M.,Armed Forces Institute of Pathology
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2010

Tuberculosis was a leading cause of death at the turn of the 20th century and continues to be one of the medical scourges of mankind. Before the availability of antimicrobial drugs the cornerstone of treatment was rest in the open air in sanatoria. The major breakthrough in treatment of tuberculosis came with the discovery of Streptomycin. Later, INH, Ethambutol. Pyrazinamide, Rifampicin were added to the arsenal. Objective of this study was to determine the sensitivity of clinical isolates of Mycobacterium tuberculosis against two second-line anti-tuberculosis drugs, Amikacin and Ciprofloxacin. This cross-sectional study was conducted at Department of Microbiology. Armed Forces Institute of Pathology (AFIP) Rawalpindi. All routine clinical samples received for acid fast bacilli (AFB) in the Department of Microbiology. AFIP, Rawalpindi were processed by modified Petroff's technique and inoculated on Lowenstein Jensen (LJ) medium and Bactec 460 Mycobacterium tuberculosis culture system. After identification of M. tuberculosis sensitivity was performed against first-line anti-tuberculosis drugs. Then susceptibility of M. tuberculosis isolates against Amikacin and Ciprofloxacin was performed on LJ medium. H37Rv was used as control strain. Results were interpreted using resistance ratio method. Out of 100 M. tuberculosis isolates, 98% were sensitive to Amikacin and 97% to Ciprofloxacin. Amikacin and Ciprofloxacin are very effective 2nd line anti-tuberculosis drugs against tuberculosis isolates in our set-up.

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