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Volume 27(5); October 1993
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Original Articles
Apoptosis Induced by Adriamycin in HeLa Cells.
Sun Young Kim, Sang Sook Lee
Korean J Pathol. 1993;27(5):433-442.
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AbstractAbstract PDF
This study was carried out to demonstrate the mode of ADR-induced cell death(apoptosis) on the light and electron microscopic features, to measure the apoptotic index dependent on various doses of ADR, to investigate the possible mechanism of apoptosis induced by ADR, and to evaluate ISNT method for the detection of DNA strand break. HeLa cells were treated with various doses of ADR 0.1~100.0 microgram/ml and observed under the light and transmission electron microscopes at 6 hours, 1 day and 3 days after ADR treatment. In addition, DNA strand breaks induced by ADR were detected in HeLa cells using the in situ nick translation(ISNT) method. The results were as follows: 1) The cell viability of HeLa cells decreased and the apoptotic index increased following exposure to ADR in a dose-dependent manner, resulting in about 44% of apoptotic index at 100.0 microgram/ml of ADR treatment. 2) Light microscopically, HeLa cells treated with ADR showed shrinkage or condensation of nucleus and cytoplasm. There were various unclear changes showing irregular, large, delineated masses of condensed chromatin abutting on the nuclear envelopes. Later stage of apoptosis revealed contracted and condensed cytoplasm with irregular cell membrane. Electron microscopically, margination of condensed chromatin, dilatation of endoplasmic reticulum under the plasma membrane, aggregation of cytoplasmic organelles with morphologically intact mitochondria, and irregular cell surface with blebbing were observed. 3) ISNT using biotinylated dUTP exhibited strong positive nuclear staining in HeLa cells treated with ADR. There was a marked response at 10.0~20.0 microgram/ml of ADR treatment. It is concluded from the above results that the death of HeLa cells induced by ADR was apoptotic in type based on light and electron microscopic appearance. The apoptotic index correlated with the increasing dose of ADR. ISNT with biotinylated dUTP led to visible evidence of DNA strand breaks following ADR treatment of HeLa cells. ISNT can be used for detection of DNA degradation, caused by activation of endogenous endonuclease, which is an early and specific characteristic of apoptosis.
Detection of Numerical Chromosomal Aberration in Squamous Cell Carcinoma of the Lung by In Situ Hybridization Using #17 Centromeric Probes.
Sang Sook Lee, Seong Beom Han, Soong Kook Park
Korean J Pathol. 1993;27(5):443-458.
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AbstractAbstract PDF
This study was carried out to understand the relationship between specific chromosome changes and their phenotypic consequences at the tissue level of human lung cancers. Then paraffin-embedded human lung squamous cell carcinoma samples were investigated for in evidence of genetic alterations, using chromosome 7 and 17-specific repetitive alpha-satellite DNA probes. In situ hybridization procedure with chromosome-specific DNA probes was optimized for use on formalin-fixed paraffin-embedded lung tissue sections. The chromosome index ranged from 1.10 to 1.88(median, 1.49) for chromosome 7 and 1.20 to 1.98(median, 1.69) for chromosome 17. Normal lymphocytes and stromal cells showed one or two chromosome signals per cell in most cases. All tumors showed three or more chromosome signals per cell with range of 16.0% to 80.6% of cancer cells(median, 50.9%) for chromosome 7 and 32.7% to 84.7%(median, 69.9%) for chromosome 17. The chromosome index did not correlate with the DNA content in most cases. Chromosomes 7 and 17 were either overrepresented or underrepresented when they were compared with corresponding DNA index determined by FCM. An increase in copy number, particularly of chromosome 7 was associated with a less favorable phenotype, including high nuclear grade. In addition, chromosome alterations were differentially expressed in the different areas of the same tissue section, correlating with histologic heterogeneity. These results suggest that chromosome polysomy can be reliably detected in tissue sections using in situ hybridization. There is a strong correlation between genotypic abnormalities and tumor phenotype in human lung cancer. This capability will prove to be an important tool for determining the underlying genetic basis for tumor development, tissue phenotype heterogeneity and progression by allowing genetic determination to be made on paraffin-embedded tissue sections where tumor histologic architecture is preserved.
Congenital Bronchopulmonary Foregut Malformation: Analysis of the surgical and autopsy cases.
Sung Hye Park, Je G Chi
Korean J Pathol. 1993;27(5):459-467.
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AbstractAbstract PDF
Because early embryonic development of the tracheobronchial tree and foregut are closely associated, there is a wide spectrum of congenital anomalies involving either one or both organ systems. We analysed a total of 89 surgical and autopsy cases that are assumed to belong to congenital bronchopulmonary foregut malformation from the files of Seoul National University Hospital and Children's Hospital during the periord of 1961~1990. We also reviewed the serial sections of the embryos and fetuses from 3 weeks to fifteen weeks fertilization age for the observation of tracheobronchial and esophageal trees. Intralobar sequestrations(25 cases) and extralobar pulmonary sequestrations(4 cases) with patent, involuted-partial or complete-communication with the alimentary tract, tracheoesophageal fistula(30 cases) with or without esophageal atresia, esophageal atresia, esophageal stenosis due to tracheobroncheal remnant(4 cases), foregut duplication cysts(3 cases), esophageal or gastric diverticulum(1 cases), and bronchogenic cysts(22 cases) are included in this analysis(Table 1). Through this study, we confirmed the unifying concept of "bronchopulmonary forgut malformations". We believe a common embryologic pathogenesis leads to the formation of a previously described spectrum of malformations.
Sequential Ultrastructural Change of Chorionic Villi in Human Placenta by Gestational Period.
Tae Dong Park, Tae Jung Kwon, Je G Chi
Korean J Pathol. 1993;27(5):468-484.
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AbstractAbstract PDF
A study was performed to observe the sequential morphological change of the human placental barrier by means of light microscopy, immunohistochemistry, scanning electron microscopy and transmission electron microscopy. The examined placentas ranged in age from 4 weeks gestation to the full-term(40 weeks). Sixty seven placental specimens were obtained immediately after delivery. With the progression of gestation, the microvilli on the surface of syncytinum tended to be fewer, shorter and blunter. The syncytiotrophoblasts were getting thinner with formation of vasculo-syncytial membrane. The cytotrophoblasts formed a continuous layer which progressively disappeared but still present in the mature villi. In view of presence of intermediate cells and remnant of desmosomes, the cytotrophoblasts appeared to form the syncytiotrophoblasts. In early pregnancy, capillary formation took place by the aggregation and differentiation of the proliferation and aggregation of endothelial cells and pericytes. Myofibroblasts in villous stroma were examined by desmin immunohistochemical staining, and detected from 19 weeks to the full-term. During last period of pregancy definitive smooth muscle cells could be demonstrated, suggesting that the presence of myofibroblasts or smooth muscle cells are closely related to the placental maturity. Scanning electron microscopy of the early placenta showed numerous syncytial sprouts representing stages in the formation of new villi, but in the late period of gestation syncytial sprouts were diminished. It is concluded that the syncytiotrophoblast is originated from the cytotrophoblast in early pregnancy as the placental barrier is formulated. Moreover, myofibroblasts and smooth muscle cells in villous stroma play important role in placental maturation.
Expression of ras Oncogene Product, MHC class II Antigen and Human Papillomavirus 16/18 DNA in Carcinomas of the Uterine Cervix.
K J Cho, Ja June Jang
Korean J Pathol. 1993;27(5):485-490.
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AbstractAbstract PDF
Immunohistochemical study for ras oncogene product(p21) and MHC class II(HLA-DR) antigen, and in situ hybridization for human papillomavirus(HPV) type 16/18 were performed on 50 squamous cell carcinomas of the uterine cervix. Activated ras and aberrant DR expression were noted in 26 cases(52%) and 11 cases(22%), respectively, without a difference between keratinizing and non-keratinizing types. No direct correlation between ras and DR expression was histologically found. p21 was diffusely distributed with a finely granular pattern in the cytoplasm. Aberrant DR expression was also diffuse, with linear staining along the cell membrane. In situ hybridization revealed HPV type 16/18 DNAs in superficial koilocytotic cells of 4 cases, in which ras or DR expression was not correlated with the presence of HPV DNA.
Scanning Electron Microscopic Findings of Hair Anomalies.
Chul Jong Yoon, Je G Chi, Hai Won Chung
Korean J Pathol. 1993;27(5):491-500.
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AbstractAbstract PDF
Scanning electron microscopic(SEM) examination of hair is an efficient and definite method for the diagnosis of hair anomaly. The Hair specimen is placed on a stub, gold coated, and directly viewed without prior fixation or treatment for identification. We have analyzed 25 cases of scalp hair and 2 cases of eyebrow that were sampled with the suspicion of hair anomalies at Seoul National University Hospital during the last 7 year period from January 1988 to June 1992. All 27 cases had certain abnormalities of the hair. They consisted of monilethrix(1 case), hair casts(4 cases), pili torti(1 case), uncombable hair syndrome(1 case), trichorrhexis nodosa(5 cases), woolly hair(5 cases) and other anomaly(1 case). Some cases of them were mixed with two or three anomalies in hairs. Their combinations were; hair casts and woolly hair(1 case), hair casts and pili torti and uncombabla hair syndrome(1 case), hair casts and uncombable hair syndrome and trichorrhexis nodosa(1 case), trichorrhexis nodosa and uncombable hair syndrome(3 cases). Most of these defects included brittleness of scales and distortion of the hair shaft.
Case Reports
Right Atrial Myxoma Showing Granulomatous Lesion with Pulmonary Infart: A case report.
Kun Chang Song, Soon Hee Jung, Dong Hwan Shin
Korean J Pathol. 1993;27(5):501-503.
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AbstractAbstract PDF
Cardiac myxoma is the most common primary tumor of the heart. The tumor contains a variety of cell types that are thought to arise from a focus of primitive pluripotential mesenchymal cells in the area of the fossa ovalis. Throughout the myxoid stroma, there are variable amounts of reticular fivers, collagen, elastic fibers and smooth muscle cells. A 38-year-old female had right atrial myxoma with multiple pulmonary infarcts. In this case, we experienced an unusual degenerative change in the tumor of granulomatous lesion consisting of hemosiderin pigments, foreign body giant cells and peculiar, spheroid, semilunar or bamboo-shaped degenerated elastic fibers. Microscopically it resembles Gamna-Gandy nodule seen in the spleen of chronic passive congestion.
Laryngeal Atresia with Tracheoesophageal Fistula: 1 case report.
Eun Kyung Kim, Je G Chi
Korean J Pathol. 1993;27(5):504-508.
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AbstractAbstract PDF
Laryngeal atresia is a very rare congenital anomaly requiring immediate tracheotomy. We present a case of laryngeal atresia with tracheoesophageal fistula who showed immediate respiratory difficulty after ligation of umbilical cord and died of aspiration pneumonia at 8 days of age. The atretic portion of larynx is composed of irregulary arranged cartilaginous tissue, bundles of intrinsic muscle and soft tissue without epithelium-lined lumen. The lungs show normal development and evidences of aspiration pneumonia.
Primary Oxalosis: A case report.
Sang Yong Song, Je G Chi, Yong Choi, Sang Jun Kim
Korean J Pathol. 1993;27(5):509-513.
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AbstractAbstract PDF
Primary oxalosis is a rare genetic disorder caused by a deficiency of the peroxisomal enzyme alanine-glyoxylate aminotransferase(type I) and D-glyceric dehydrogenase(type II). It is characterized by the triad of radiopaque urolithiasis, nephrocalcinosis, and latered renal function. We report a case of primary oxalosis in a 10-year-old Korean girl. She presented with chronic renal failure at 9 years of age. Ultrasonographic examination revealed bilateral, multiple renal and ureteral stones. Removed stones were chemically analysed to be composed of calcium oxalate. She underwent renal transplantation after prolonged period of dialysis. Removed kidneys were firm and gritty. Cut sections showed numerous tiny yellow sandy stones and a large staghorn stone. Specimen X-ray also exhibited disseminated fine granular and often coalescent radiopaque materials throughout the cortex and medulla. Microscopically numerous varying-sized crystals were noted in the kidney in globular or rhomboid appearance. The crystals were semitranslucent and doubly refractile under the polarized light. Diffuse interstitial fibrosis and chronic inflammation as well as glomerular obsolescence were also noted. The oxalate deposit was diffuse and marked, and was thought to be intimately related to the parenchymal damage and fibrosis.
Original Articles
Nongestational Choriocarcinoma of the Overy.
Jeong Hee Kang, Hae Jin Lee, Sun Kyung Lee
Korean J Pathol. 1993;27(5):514-517.
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AbstractAbstract PDF
Most instances of choriocarcinoma of the ovary are gestational in origin. In contrast, nongestational choriocarcinoma of the ovary is an exceedingly rare primary germ cell neoplasm that has worse prognosis than gestational neoplasm. We report a case of pure nongestational choriocarcinoma of the ovary in view of the rarity of its kind. The patient was a 35-year-old Korean unmarried woman who had suffered from vaginal bleeding and feeling of abdominal inflation for two months. The X-ray studies and CT scanning revealed a child head sized cystic mass on the right pelvic cavity and multiple nodular densities in both lung fields and the liver. The mass in pelvic cavity was excised and histologically confirmed to be a nongestational pure choriocarcinoma, arising from the right side ovary.
Papillary Eccrine Adenoma: Histopathological and Immunohistochemical study.
Chan Kum Park
Korean J Pathol. 1993;27(5):518-523.
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Papillary eccrine adenoma is a rare benign sweat gland neoplasm. However, it can show locally aggressive clinical course when it is incompletely removed. A case of papillary eccrine adenoma of the thigh of a 46-year-old woman is reported. Immunohistochemical studies showed that this tumor was diffusely positive for cytokeratin(CAM 5.2), and carcinoembryonic antigen, and focally positive for EMA in the luminal cells of the neoplastic ducts. S-100 protein was not stained in the luminal cells and myoepithelial cells of neoplastic ducts. Papillary eccrine adenoma appears to differentiate toward ductal structures of the eccrine sweat apparatus.
Optic Nerve Glioma with Neurofibromatosis.
Na Hye Myong, Seung Sook Lee, Yun Lim Shu, Je G Chi
Korean J Pathol. 1993;27(5):524-530.
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AbstractAbstract PDF
Optic nerve gliomas manifest either as a solitary form or a component of von Recklinghausen's neurofibromatosis. The reported incidence of coexistence with neurofibromatosis varies from 12% to 70%. Usually there are no significant cytological differences between the gliomas that accomapny the disease and those that are deemed to be solitary manifestations. The only possible difference between them is the apparently more common association, with the former, of extensive arachnoid hyperplasia and of a more florid local gliomatous infiltration into the leptomeninges, altogether resulting in perineural thickening. Our cases were 8 and 6 years old girls, respectively, presented with slowly progressive proptosis for 4 years and visual disturbance for 2.5 months. There were multiple cafe au lait spots on their trunks, and case 2 showed Lisch nodules in the iris. MRI of brain revealed unilateral optic nerve thickening with involvement of chiasm or multiple intracranial lesions. Resection of optic nerve tumor was performed. Microscopically, variable degree of tumorous change was seen. Most typically enlarged area was composed of intraneural and perineural portions surrounded by a layer of intact dura. Intraneural tumor revealed proliferation of elongated, spindle-shaped pilocytic astrocytes in intertrabecular spaces and distention of the pial septa with fibrovascular thickening. Another segment had areas with reactive gliosis. Perineural tissue was considerably thickened and, associated with proliferation of meningothelial cells and fibroblasts intermingled with astrocytes and Rosenthal fibers. There were increase of the optic nerve diameter and distention of the overlying dura. Foci of arachnoid cell hyperplasia were noted in both cases, although differed in degree. Immunohistochemically, the tumor cells expressed glial fibrillary acidic protein in intraneural and perineural portions particularly in case 2.
Case Reports
Chromomycosis of the Skin: A case report.
Tae Sook Kim, Kye Yong Song, Je G Chi
Korean J Pathol. 1993;27(5):531-534.
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AbstractAbstract PDF
Cutaneous chromomycosis is a slow growing verrucous skin infection caused by five species, identified as Philadophara verruscosa, Fonsecaea dermatitidis, Fonsecaea pedrosoi, Fonsecaea compactum, Cladosporium, carionii. We report a case of chromomycosis of the skin causing by Cladosporium genus, in view of its rarity and unique light microscopic and ultrastructural features. This 65-year-old female had suffered from eczematous and lichenified skin lesion for the last two years since she burned her dorsum of the left hand by boiling oil. The lesion was slowly progressed, and ended up to the brownish hardening of the skin covered with crusts. Skin punch biopsy was done. Histologically, the sections revealed typical features of chronic granulomatous inflammation along with the heavy infiltration of the lymphocytes, plasma cells and histiocytes. Pseudocarcinomatous downgrowth of the epidermis and microabscesses in the upper dermis were also found. Numerous thick walled fungal organisms were noted within the giant cells and freely in the dermis, which were positive ant PAS stain, and diastase resistant. Thick mucous capsule is not observed. The organisms showed very faint yellowish walls with a few buddings and a few short elongated hyphae were also noted. Ultrastructurally, the fungus wall was multilayered and inner organelles were sparse. There is no evidence of systemic involvement, especially brain.
Lipoleiomyoma of the Uterus: A case report.
Myung Sook Kang, Young Hee Maeng, Jae Hoon Park, Yun Wha Kim, Ju Hee Lee, Moon Ho Yang
Korean J Pathol. 1993;27(5):535-537.
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AbstractAbstract PDF
A rare case of uterine lipoleiomyoma is reported with presentation of computed tomography, histomorphologic and immunohistochemical findings. This tumor is predominantly lipomatous with an admixture of smooth muscle fiber and hyalinized fibrous tissue. Immunohistochemical study revealed a positive reaction of S-100 protein in fat cells and desmin in smooth muscle fibers. Its histogenesis also has been discussed.
Malignant Eccrine Acrospiroma: A case report.
Gil Ro Han, In Sun Kim, Kye Yong Song, Ki Duck Kim, Beom Woo Yeom, Jong Sang Choi
Korean J Pathol. 1993;27(5):538-541.
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AbstractAbstract PDF
A case of malignant eccrine acrospiroma of the anterior chest wall is reported. This mass had been present for 20 years and during rescent 5 years it showed frequent ulceration and bleeding suggesting malignant transformation. Microscopically, several foci malignant transformation from preexisting benign eccrine acrospiroma are seen and in immunohistochemical staining, the tumor cells both benign and malignant portion, show positive reaction to cytokeratin.

J Pathol Transl Med : Journal of Pathology and Translational Medicine