Medical schools are increasingly integrating professionalism training into their gross anatomy courses, teaching ethical behavior and humanistic attitudes through the dissection experience. However, many schools continue to take a traditional, technical approach to anatomical education while teaching professionalism in separate courses. This interview‐based study explored how students viewed the body donor and the professional lessons they learned through dissection at one such medical school. All students oscillated involuntarily between seeing the cadaver as a specimen for learning and seeing the cadaver as a person, with some students intentionally cultivating one of these ways of seeing over the other. These views shaped students’ emotional and moral responses to the experiences of dissection. The “specimen” view facilitated a technical, detached approach to dissection, while the “person” view made students engage emotionally. Further, students who intentionally cultivated a “specimen” view generally felt less moral distress about dissection than students who intentionally cultivated a “person” view. The concept of respect gave students permission to perform dissections, but “person‐minded” students developed more complex rules around what constituted respectful behavior. Both groups of students connected the gross anatomy experience to their professional development, but in different ways. “Specimen‐minded” students intentionally objectified the body to learn the emotional control physicians need, while “person‐minded” students humanized the body donor to promote the emotional engagement required of physicians. These findings support efforts to integrate professionalism teaching into gross anatomy courses, particularly content, addressing the balance between professional detachment and concern.

Nearly half of clinically low risk patients harbor Gleason 7 or greater, or pT3 or greater disease, and should be risk stratified by prostate specific antigen and percent positive cores for consideration of further testing before deciding on active surveillance.

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ObjectivesTo describe outcomes of patients with prostate cancer diagnosed after another malignancy and identify factors associated with prostate cancer death in this population, as little is known about the clinical significance of prostate cancer as a subsequent malignancy. Patients and MethodsWe studied 18 225 men diagnosed with prostate cancer after another malignancy from 1973 to 2006. We compared demographic and clinical variables, and the proportion of death from prostate cancer vs prior malignancy with t-test and chi-squared analyses. Fine and Gray's regression was used to consider the effect of treatment on prostate cancer death. We then studied a second cohort of 88 013 men with prostate cancer as a first or second malignancy to describe current diagnostic and treatment patterns. ResultsOne in seven men died from prostate cancer in our first cohort. More died from prostate cancer following colorectal cancer (16.8% vs 13.7%), melanoma (13.4% vs 7.56%), and oral cancer (19.1% vs 4.04%), but fewer following bladder cancer, kidney cancer, lung cancer, leukaemia and nonHodgkin's lymphoma (all P < 0.001). Prostate cancer treatment was associated with a nearly 50% lower risk of death when high-grade or high-stage (adjusted hazard ratio 0.55, 95% confidence interval [CI] 0.47-0.64). Patients who died from prostate cancer had higher grade and stage disease, and received less treatment than patients who died from prior malignancy. The second cohort showed subsequent prostate cancer had more high-risk disease (36.3% vs 22.2%, P < 0.001) and less prostate cancer treatment (adjusted odds ratio 0.872, 95% CI 0.818-0.930) than primary prostate cancer. ConclusionsProstate cancer remains a significant cause of mortality when diagnosed as a subsequent cancer. These results suggest prostate cancer treatment should be seriously considered in patients with prior malignancies, especially those with highgrade or locally advanced prostate cancer.

Background: Skin adnexal tumours are a category of rare tumours. They usually present as painless nodules and papules. The diagnosis of these tumours poses a challenge, because there is usually a discrepancy in clinical and histopathological diagnosis. Aims: To study the skin biopsies received in our department and compare their clinical and histopathological diagnosis. Material and methods: Prospective study of skin biopsies received in our department over a period of 1 year. The biopsies were processed and stained with haematoxylin and eosin and studied under the light microscope. Results: Out of the 26 cases studied, 25 were found to be benign tumours with a single case of keratoacanthoma. The most common tumour encountered was pilomatricoma and the least common was syringoma. Only four cases showed clinical correlation with histopathological diagnosis. Conclusion: It can be therefore concluded that skin adnexal tumours are rare tumours which need histopathological examination for their accurate diagnosis.

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PurposeTo compare the short-term effect of anatomic video-assisted thoracoscopic surgery (VATS) segmentectomy and VATS lobectomy.Patients and methodsFrom January 2011 to December 2012, 21 patients underwent VATS segmentectomy and 61 underwent VATS lobectomy. Intraoperative blood loss, operating time, postoperative drainage time, length of hospital stay, postoperative complications, local recurrence, and survival were compared between the two groups.ResultsThe intraoperative blood loss and average hospital stay were less in the segmentectomy group than in the lobectomy group (P<0.05). There was no significant difference in the operating time, number of lymph nodes dissected, postoperative drainage time, or 1-year survival between the two groups (P>0.05). Only one patient died because of heart disease. The two groups had a similar incidence of postoperative complications (P>0.05). There was one (4.8%) local recurrence after segmentectomy and two (3.3%) after lobectomy (P>0.05).ConclusionVATS segmentectomy could be performed safely and is a method with favorable 1-year survival. It may be the ideal surgical procedure for patients with solitary pulmonary nodules in early stage lung cancer, especially for those with limited cardiopulmonary reserve or significant comorbidities.

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