Journal of Pathology and Translational Medicine

Original Article

Association study of TYMS gene expression with TYMS and ENOSF1 genetic variants in neoadjuvant chemotherapy response of gastric cancer: Khadijeh Arjmandi, Iman Salahshourifar, Shiva Irani, Fereshteh Ameli, Mohsen Esfandbod; J Pathol Transl Med. 2025;59(2):105-114. Published online February 25, 2025; DOI: https://doi.org/10.4132/jptm.2024.11.05

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Background
The present research was designed to study the associations between genetic variants of TYMS and ENOSF1 genes with TYMS and ENOSF1 gene expression in neoadjuvant chemotherapy response among patients with gastric cancer. Methods: Formalin-embedded and paraffin-fixed matched tumor and normal gastric cancer tissue samples from patients who received neoadjuvant 5-fluorouracil (5-FU) treatment were obtained. DNA and RNA were extracted for all samples. A 28-bp variable number tandem repeat (VNTR) at the 5' untranslated region of TYMS gene and rs2612091 and rs2741171 variants in the ENOSF1 gene were genotyped for normal tissue samples. The real-time polymerase chain reaction method was used to study the expression of ENOSF1 and TYMS genes in both normal and tumor tissues. Data were analyzed using REST 2000 and SPSS ver. 26.0 software programs. Results: A significant association between TYMS 2R3R VNTR genotypes and 5-FU therapy was found (p = .032). The 3R3R and 2R2R genotypes were significantly associated with increased and decreased survival time, respectively (p = .003). The 3R3R genotype was significantly associated with TYMS overexpression (p < .001). Moreover, a significant association was found between the rs2612091 genotype and treatment outcome (p = .017). Conclusions: This study highlights the impact of TYMS and ENOSF1 genes as predictive indicators for survival and response to 5-FU–based neoadjuvant chemotherapy in gastric cancer patients.

Citations

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Innovative biomaterial strategies for mitigating radiotherapy toxicity: multidimensional mechanistic interventions of nano-microscale materials and hydrogels
Yifan Liu, Fengdi Jiang, Jie Song, Huaijin Qiao, Junlong Dai, Hao Bai, Shuyu Zhang
Coordination Chemistry Reviews.2026; 549: 217313. CrossRef
Mebendazole impairs the expression and function of enzymes in nucleotide metabolism pathways, leading to Selective Cytotoxicity, Cell Cycle Arrest, and Damage to Cell Morphology in Gastric Cancer
Emerson Lucena da Silva, Felipe Pantoja Mesquita, Pedro Victor da Rocha Lima, José Hélio de Araújo Filho, Francisco Laio de Oliveira, Ana Beatriz da Lima, Pedro Filho Noronha Souza, Raquel Carvalho Montenegro
Chemico-Biological Interactions.2026; 430: 111973. CrossRef

Reviews

Development of CytoAcademy: a new web- and mobile-based E-learning platform for cytopathologists and cytotechnologists by the Korean Society for Cytopathology in the post-pandemic era: Ran Hong, Yosep Chong, Seung Wan Chae, Seung-Sook Lee, Gyungyub Gong; J Pathol Transl Med. 2024;58(6):261-264. Published online November 7, 2024; DOI: https://doi.org/10.4132/jptm.2024.10.02

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Abstract PDF

Since the late 1990s, online e-learning has offered unparalleled convenience and affordability, becoming increasingly popular among pathologists. Traditional learning theories have been successfully applied to web/mobile-based learning systems, with mobile technologies even enhancing conventional offline education. In cytopathology, hands-on microscope training has traditionally been paramount, complemented by real-case presentations and lectures. However, the coronavirus disease 2019 (COVID-19) pandemic disrupted regular academic activities, making online e-learning platforms essential. We designed a web/mobile-based learning platform to enhance continued medical education in cytopathology at various levels, particularly during the era of COVID-19 and beyond. Since 2021, we have integrated curriculum materials, virtual education files, and whole-slide images (WSIs) of cytopathology, submitted from over 200 institutions across Korea, with the support of numerous instructors. We develop a new e-learning platform named “CytoAcademy” composed of a basic session for each organ and level across the range of morphologic findings; on-demand lectures to enhance cytopathologic knowledge; WSI archives that allow users to explore various histologically confirmed cases; and a self-assessment test to help organize diagnostic knowledge acquired through the web/mobile-friendly learning system. The platform provides not just an opportunity to achieve a correct diagnosis, but also a learning experience based on problem-solving point. Members interact, identify their deficiencies, and focus on specific educational materials. In this manner, all participants can actively engage in creating and maintaining knowledge and foster a proactive approach to learning.

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Practice of Cytopathology in Korea: A 40‐Year Evolution Through Standardization, Digital Transformation, and Global Partnership
Yosep Chong, Ran Hong, Hyeong Ju Kwon, Haeryoung Kim, Lucia Kim, Soon Jae Kim, Yoon Jung Choi
Diagnostic Cytopathology.2026; 54(2): 146. CrossRef
Developing a smart and scalable tool for histopathological education—PATe 2.0
Lina Winter, Annalena Artinger, Hendrik Böck, Vignesh Ramakrishnan, Bruno Reible, Jan Albin, Peter J. Schüffler, Georgios Raptis, Christoph Brochhausen
Journal of Pathology Informatics.2026; 20: 100535. CrossRef
National quality assurance program using digital cytopathology: a 5-year digital transformation experience by the Korean Society for Cytopathology
Yosep Chong, Hyeong Ju Kwon, Soon Auck Hong, Sung Soon Kim, Bo-Sung Kim, Younghee Choi, Yoon Jung Choi, Jung-Soo Pyo, Ji Yun Jeong, Soo Jin Jung, Hoon Kyu Oh, Seung-Sook Lee
Journal of Pathology and Translational Medicine.2025; 59(5): 320. CrossRef
Integration of Digital Cytology in Quality Assurance Programs for Cytopathology
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Acta Cytologica.2025; 70(1): 126. CrossRef

Clinical practice recommendations for the use of next-generation sequencing in patients with solid cancer: a joint report from KSMO and KSP: Miso Kim, Hyo Sup Shim, Sheehyun Kim, In Hee Lee, Jihun Kim, Shinkyo Yoon, Hyung-Don Kim, Inkeun Park, Jae Ho Jeong, Changhoon Yoo, Jaekyung Cheon, In-Ho Kim, Jieun Lee, Sook Hee Hong, Sehhoon Park, Hyun Ae Jung, Jin Won Kim, Han Jo Kim, Yongjun Cha, Sun Min Lim, Han Sang Kim, Choong-Kun Lee, Jee Hung Kim, Sang Hoon Chun, Jina Yun, So Yeon Park, Hye Seung Lee, Yong Mee Cho, Soo Jeong Nam, Kiyong Na, Sun Och Yoon, Ahwon Lee, Kee-Taek Jang, Hongseok Yun, Sungyoung Lee, Jee Hyun Kim, Wan-Seop Kim; J Pathol Transl Med. 2024;58(4):147-164. Published online January 10, 2024; DOI: https://doi.org/10.4132/jptm.2023.11.01

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Abstract PDF

In recent years, next-generation sequencing (NGS)–based genetic testing has become crucial in cancer care. While its primary objective is to identify actionable genetic alterations to guide treatment decisions, its scope has broadened to encompass aiding in pathological diagnosis and exploring resistance mechanisms. With the ongoing expansion in NGS application and reliance, a compelling necessity arises for expert consensus on its application in solid cancers. To address this demand, the forthcoming recommendations not only provide pragmatic guidance for the clinical use of NGS but also systematically classify actionable genes based on specific cancer types. Additionally, these recommendations will incorporate expert perspectives on crucial biomarkers, ensuring informed decisions regarding circulating tumor DNA panel testing.

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Apport de la génomique dans la prise en charge des cancers
Étienne Rouleau, Lucie Karayan-Tapon, Marie-Dominique Galibert, Alexandre Harlé, Isabelle Soubeyran
Revue Francophone des Laboratoires.2025; 2025(568): 67. CrossRef
The Redox–Adhesion–Exosome (RAX) Hub in Cancer: Lipid Peroxidation-Driven EMT Plasticity and Ferroptosis Defense with HNE/MDA Signaling and Lipidomic Perspectives
Moon Nyeo Park, Jinwon Choi, Rosy Iara Maciel de Azambuja Ribeiro, Domenico V. Delfino, Seong-Gyu Ko, Bonglee Kim
Antioxidants.2025; 14(12): 1474. CrossRef

Case Study

A rare goblet cell adenocarcinoma arising from Barrett’s esophagus: the first reported case in the esophagus: Chi Eun Oh, Sung Eun Kim, Sun-Ju Oh; J Pathol Transl Med. 2024;58(2):81-86. Published online January 8, 2024; DOI: https://doi.org/10.4132/jptm.2023.12.26

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Abstract PDF: Goblet cell adenocarcinoma (GCA) is a rare and distinctive amphicrine tumor comprised of goblet-like mucinous cells and neuroendocrine cells. It is believed to originate from pluripotent stem cells located at the base of crypts. GCA predominantly arises from the appendix, with a few reported cases in extra-appendiceal locations such as the colorectum, small intestine, and stomach. In this case report, we present a unique instance of a 64-year-old male who initially received a diagnosis of neuroendocrine carcinoma in the distal esophagus based on biopsy but, following resection, was subsequently re-diagnosed with GCA arising from Barrett’s esophagus.

Original Articles

Postmortem lung and heart examination of COVID-19 patients in a case series from Jordan: Maram Abdaljaleel, Isra Tawalbeh, Malik Sallam, Amjad Bani Hani, Imad M. Al-Abdallat, Baheth Al Omari, Sahar Al-Mustafa, Hasan Abder-Rahman, Adnan Said Abbas, Mahmoud Zureigat, Mousa A. Al-Abbadi; J Pathol Transl Med. 2023;57(2):102-112. Published online March 14, 2023; DOI: https://doi.org/10.4132/jptm.2023.01.30

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Abstract PDF: Background
Coronavirus disease 2019 (COVID-19) has emerged as a pandemic for more than 2 years. Autopsy examination is an invaluable tool to understand the pathogenesis of emerging infections and their consequent mortalities. The aim of the current study was to present the lung and heart pathological findings of COVID-19–positive autopsies performed in Jordan.
Methods
The study involved medicolegal cases, where the cause of death was unclear and autopsy examination was mandated by law. We included the clinical and pathologic findings of routine gross and microscopic examination of cases that were positive for COVID-19 at time of death. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed through molecular detection by real-time polymerase chain reaction, serologic testing for IgM and electron microscope examination of lung samples.
Results
Seventeen autopsies were included, with male predominance (76.5%), Jordanians (70.6%), and 50 years as the mean age at time of death. Nine out of 16 cases (56.3%) had co-morbidities, with one case lacking such data. Histologic examination of lung tissue revealed diffuse alveolar damage in 13/17 cases (76.5%), and pulmonary microthrombi in 8/17 cases (47.1%). Microscopic cardiac findings were scarcely detected. Two patients died as a direct result of acute cardiac disease with limited pulmonary findings.
Conclusions
The detection of SARS-CoV-2 in postmortem examination can be an incidental or contributory finding which highlights the value of autopsy examination to determine the exact cause of death in controversial cases.

Usefulness of BRAF VE1 immunohistochemistry in non–small cell lung cancers: a multi-institutional study by 15 pathologists in Korea: Sunhee Chang, Yoon-La Choi, Hyo Sup Shim, Geon Kook Lee, Seung Yeon Ha; J Pathol Transl Med. 2022;56(6):334-341. Published online October 27, 2022; DOI: https://doi.org/10.4132/jptm.2022.08.22

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Abstract PDF

Background
Next-generation sequencing (NGS) is an approved test to select patients for BRAF V600E targeted therapy in Korea. However, the high cost, long turnaround times, and the need for sophisticated equipment and skilled personnel limit the use of NGS in daily practice. Immunohistochemistry (IHC) is a rapid and relatively inexpensive assay available in most laboratories. Therefore, in this study, we evaluate the usefulness of BRAF VE1 IHC in terms of predictive value and interobserver agreement in non–small cell lung cancers (NSCLCs).
Methods
A total of 30 cases with known BRAF mutation status were selected, including 20 cases of lung adenocarcinomas, six cases of colorectal adenocarcinomas, and four cases of papillary thyroid carcinomas. IHC for BRAF V600E was carried out using the VE1 antibody. Fifteen pathologists independently scored both the staining intensity and the percentage of tumor cell staining on whole slide images.
Results
In the lung adenocarcinoma subset, interobserver agreement for the percentage of tumor cell staining and staining intensity was good (percentage of tumor cell staining, intraclass correlation coefficient = 0.869; staining intensity, kappa = 0.849). The interobserver agreement for the interpretation using the cutoff of 40% was almost perfect in the entire study group and the lung adenocarcinoma subset (kappa = 0.815). Sensitivity, specificity, positive predictive value, and negative predictive value of BRAF VE1 IHC were 80.0%, 90.0%, 88.9%, and 81.8%, respectively.
Conclusions
BRAF VE1 IHC could be a screening test for the detection of BRAF V600E mutation in NSCLC. However, further studies are needed to optimize the protocol and to establish and validate interpretation criteria for BRAF VE1 IHC.

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Dedifferentiated Leiomyosarcoma of the Uterine Corpus with Heterologous Component: Clinicopathological Analysis of Five Consecutive Cases from a Single Institution and Comprehensive Literature Review
Suyeon Kim, Hyunsik Bae, Hyun-Soo Kim
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Reviews

Standardization of the pathologic diagnosis of appendiceal mucinous neoplasms: Dong-Wook Kang, Baek-hui Kim, Joon Mee Kim, Jihun Kim, Hee Jin Chang, Mee Soo Chang, Jin-Hee Sohn, Mee-Yon Cho, So-Young Jin, Hee Kyung Chang, Hye Seung Han, Jung Yeon Kim, Hee Sung Kim, Do Youn Park, Ha Young Park, So Jeong Lee, Wonae Lee, Hye Seung Lee, Yoo Na Kang, Younghee Choi; J Pathol Transl Med. 2021;55(4):247-264. Published online July 8, 2021; DOI: https://doi.org/10.4132/jptm.2021.05.28

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Abstract PDF Supplementary Material

Although the understanding of appendiceal mucinous neoplasms (AMNs) and their relationship with disseminated peritoneal mucinous disease have advanced, the diagnosis, classification, and treatment of AMNs are still confusing for pathologists and clinicians. The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists (GPSG-KSP) proposed a multicenter study and held a workshop for the “Standardization of the Pathologic Diagnosis of the Appendiceal Mucinous Neoplasm” to overcome the controversy and potential conflicts. The present article is focused on the diagnostic criteria, terminologies, tumor grading, pathologic staging, biologic behavior, treatment, and prognosis of AMNs and disseminated peritoneal mucinous disease. In addition, GPSG-KSP proposes a checklist of standard data elements of appendiceal epithelial neoplasms to standardize pathologic diagnosis. We hope the present article will provide pathologists with updated knowledge on how to handle and diagnose AMNs and disseminated peritoneal mucinous disease.

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Molecular biomarker testing for non–small cell lung cancer: consensus statement of the Korean Cardiopulmonary Pathology Study Group: Sunhee Chang, Hyo Sup Shim, Tae Jung Kim, Yoon-La Choi, Wan Seop Kim, Dong Hoon Shin, Lucia Kim, Heae Surng Park, Geon Kook Lee, Chang Hun Lee; J Pathol Transl Med. 2021;55(3):181-191. Published online May 11, 2021; DOI: https://doi.org/10.4132/jptm.2021.03.23

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Abstract PDF

Molecular biomarker testing is the standard of care for non–small cell lung cancer (NSCLC) patients. In 2017, the Korean Cardiopulmonary Pathology Study Group and the Korean Molecular Pathology Study Group co-published a molecular testing guideline which contained almost all known genetic changes that aid in treatment decisions or predict prognosis in patients with NSCLC. Since then there have been significant changes in targeted therapies as well as molecular testing including newly approved targeted drugs and liquid biopsy. In order to reflect these changes, the Korean Cardiopulmonary Pathology Study Group developed a consensus statement on molecular biomarker testing. This consensus statement was crafted to provide guidance on what genes should be tested, as well as methodology, samples, patient selection, reporting and quality control.

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PD-L1 Testing in Non-small Cell Lung Cancer: Past, Present, and Future: Hyojin Kim, Jin-Haeng Chung; J Pathol Transl Med. 2019;53(4):199-206. Published online May 2, 2019; DOI: https://doi.org/10.4132/jptm.2019.04.24; Correction in: J Pathol Transl Med 2020;54(2):196

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Abstract PDF

Blockade of the programmed cell death-1 (PD-1) axis has already been established as an effective treatment of non-small cell lung cancer. Immunohistochemistry (IHC) for programmed death-ligand 1 (PD-L1) protein is the only available biomarker that can guide treatment with immune checkpoint inhibitors in non-small cell lung cancer. Because each PD-1/PD-L1 blockade was approved together with a specific PD-L1 IHC assay used in the clinical trials, pathologists have been challenged with performing various assays with a limited sample. To provide a more unified understanding of this, several cross-validation studies between platforms have been performed and showed consistent results. However, the interchangeability of assays may be limited in practice because of the risk of misclassification of patients for the treatment. Furthermore, several issues, including the temporal and spatial heterogeneity of PD-L1 expression in the tumor, and the potential for cytology specimens to be used as an alternative to tissue samples for PD-L1 testing, have still not been resolved. In the future, one of the main aims of immunotherapy research should be to find a novel predictive biomarker for PD-1 blockade therapy and a way to combine it with PD-L1 IHC and other tests.

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Molecular Testing of Lung Cancers: Hyo Sup Shim, Yoon-La Choi, Lucia Kim, Sunhee Chang, Wan-Seop Kim, Mee Sook Roh, Tae-Jung Kim, Seung Yeon Ha, Jin-Haeng Chung, Se Jin Jang, Geon Kook Lee; J Pathol Transl Med. 2017;51(3):242-254. Published online April 21, 2017; DOI: https://doi.org/10.4132/jptm.2017.04.10

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Abstract PDF

Targeted therapies guided by molecular diagnostics have become a standard treatment of lung cancer. Epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements are currently used as the best predictive biomarkers for EGFR tyrosine kinase inhibitors and ALK inhibitors, respectively. Besides EGFR and ALK, the list of druggable genetic alterations has been growing, including ROS1 rearrangements, RET rearrangements, and MET alterations. In this situation, pathologists should carefully manage clinical samples for molecular testing and should do their best to quickly and accurately identify patients who will benefit from precision therapeutics. Here, we grouped molecular biomarkers of lung cancers into three categories—mutations, gene rearrangements, and amplifications—and propose expanded guidelines on molecular testing of lung cancers.

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Original Articles

Size of Non-lepidic Invasive Pattern Predicts Recurrence in Pulmonary Mucinous Adenocarcinoma: Morphologic Analysis of 188 Resected Cases with Reappraisal of Invasion Criteria: Soohyun Hwang, Joungho Han, Misun Choi, Myung-Ju Ahn, Yong Soo Choi; J Pathol Transl Med. 2017;51(1):56-68. Published online October 16, 2016; DOI: https://doi.org/10.4132/jptm.2016.09.17

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Abstract PDF

Background
We reviewed a series of 188 resected pulmonary mucinous adenocarcinomas (MAs) to clarify the prognostic significance of lepidic and non-lepidic patterns.
Methods
Non-lepidic patterns were divided into bland, non-distorted acini with uncertain invasiveness (pattern 1), unequivocal invasion into stroma (pattern 2), or invasion into alveolar spaces (pattern 3).
Results
The mean proportion of invasive patterns (patterns 2 and 3) was lowest in small (≤ 3 cm) tumors, and gradually increased in intermediate (> 3 cm and ≤ 7 cm) and large (> 7 cm) tumors (8.4%, 34.3%, and 50.1%, respectively). Adjusted T (aT) stage, as determined by the size of invasive patterns, was positively correlated with adverse histologic and clinical features including older age, male sex, and ever smokers. aTis tumors, which were exclusively composed of lepidic pattern (n = 9), or a mixture of lepidic and pattern 1 (n = 40) without any invasive patterns, showed 100% disease- free survival (DFS). The aT1mi tumors, with minimal (≤ 5 mm) invasive patterns (n = 63), showed a 95.2% 5-year DFS, with recurrences (n = 2) limited to tumors greater than 3 cm in total size (n = 23). Both T and aT stage were significantly associated with DFS; however, survival within the separate T-stage subgroups was stratified according to the aT stage, most notably in the intermediatestage subgroups. In multivariate analysis, the size of invasive patterns (p = .020), pleural invasion (p < .001), and vascular invasion (p = .048) were independent predictors of recurrence, whereas total size failed to achieve statistical significance (p = .121).
Conclusions
This study provides a rationale for histologic risk stratification in pulmonary MA based on the extent of invasive growth patterns with refined criteria for invasion.

Citations

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Distinct Recurrence Pattern and Survival Outcomes of Invasive Mucinous Adenocarcinoma of the Lung: The Potential Role of Local Therapy in Intrapulmonary Spread
Dong Woog Yoon, Soohyun Hwang, Tae Hee Hong, Yoon-La Choi, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Young Mog Shim, Jong Ho Cho
Annals of Surgical Oncology.2024; 31(1): 201. CrossRef
Pulmonary invasive mucinous adenocarcinoma
Wei‐Chin Chang, Yu Zhi Zhang, Andrew G Nicholson
Histopathology.2024; 84(1): 18. CrossRef
Micropapillary Pattern in Invasive Mucinous Adenocarcinoma of the Lung: Comparison With Invasive Non-Mucinous Adenocarcinoma
Hui He, Lue Li, Yuan-yuan Wen, Li-yong Qian, Zhi-qiang Yang
International Journal of Surgical Pathology.2024; 32(5): 926. CrossRef
Radiological and clinical features of screening-detected pulmonary invasive mucinous adenocarcinoma
Dae Hyeon Kim, So Young Bae, Kwon Joong Na, Samina Park, In Kyu Park, Chang Hyun Kang, Young Tae Kim
Interactive CardioVascular and Thoracic Surgery.2022; 34(2): 229. CrossRef
Micropapillary Pattern in Invasive Mucinous Adenocarcinoma of the Lung: Comparison with Invasive Non-Mucinous Adenocarcinoma
Hui He, Yuanyuan Wen, Liyong Qian, Zhiqiang Yang
SSRN Electronic Journal .2022;[Epub] CrossRef
Optimal method for measuring invasive size that predicts survival in invasive mucinous adenocarcinoma of the lung
Tomonari Oki, Keiju Aokage, Shogo Nomura, Kenta Tane, Tomohiro Miyoshi, Norihiko Shiiya, Kazuhito Funai, Masahiro Tsuboi, Genichiro Ishii
Journal of Cancer Research and Clinical Oncology.2020; 146(5): 1291. CrossRef
Prognostic Impact of Histopathologic Features in Pulmonary Invasive Mucinous Adenocarcinomas
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Review of Medical Advisory Services by the Korean Society of Pathologists from 2003 to 2014: Min Hye Jang, Geon Kook Lee, Han Seong Kim, Wan Seop Kim; J Pathol Transl Med. 2016;50(1):37-44. Published online November 17, 2015; DOI: https://doi.org/10.4132/jptm.2015.09.18

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Abstract PDF Supplementary Material: Background
Since 2003, the Korean Society of Pathologists (KSP) has been officially providing medical advisory services (MAS). We reviewed the cases submitted to the KSP between 2003 and 2014. Methods: In total, 1,950 cases were submitted, most by private health insurance companies. The main purposes of the consultations were to clarify the initial diagnoses and to assign a proper disease classification code. We comprehensively reviewed 1,803 consultation cases with detailed information. Results: In spite of some fluctuations, the number of submitted cases has been significantly increasing over the 12 study years. The colon and rectum (40.3%), urinary bladder (14.2%), and stomach (6.9%) were the three most common tissues of origin. The most common diagnoses for each of the three tissues of origin were neuroendocrine tumor (50.7%), non-invasive papillary urothelial carcinoma (70.7%), and adenocarcinoma (36.2%). Regardless of the tissue of origin, neuroendocrine tumor of the digestive system was the most common diagnosis (419 of 1,803). Conclusions: In the current study, we found that pathologic consultations associated with private health insurance accounted for a large proportion of the MAS. Coding of the biologic behavior of diseases was the main issue of the consultations. In spite of the effort of the KSP to set proper guidelines for coding and classification of tumors, this review revealed that problems still exist and will continue to be an important issue.

Reviews

Molecular Dimensions of Gastric Cancer: Translational and Clinical Perspectives: Yoon Young Choi, Sung Hoon Noh, Jae-Ho Cheong; J Pathol Transl Med. 2016;50(1):1-9. Published online October 26, 2015; DOI: https://doi.org/10.4132/jptm.2015.09.10

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Abstract PDF

Gastric cancer is a global health burden and has the highest incidence in East Asia. This disease is complex in nature because it arises from multiple interactions of genetic, local environmental, and host factors, resulting in biological heterogeneity. This genetic intricacy converges on molecular characteristics reflecting the pathophysiology, tumor biology, and clinical outcome. Therefore, understanding the molecular characteristics at a genomic level is pivotal to improving the clinical care of patients with gastric cancer. A recent landmark study, The Cancer Genome Atlas (TCGA) project, showed the molecular landscape of gastric cancer through a comprehensive molecular evaluation of 295 primary gastric cancers. The proposed molecular classification divided gastric cancer into four subtypes: Epstein-Barr virus–positive, microsatellite unstable, genomic stable, and chromosomal instability. This information will be taken into account in future clinical trials and will be translated into clinical therapeutic decisions. To fully realize the clinical benefit, many challenges must be overcome. Rapid growth of high-throughput biology and functional validation of molecular targets will further deepen our knowledge of molecular dimensions of this cancer, allowing for personalized precision medicine.

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The Utilization of Cytologic Fine-Needle Aspirates of Lung Cancer for Molecular Diagnostic Testing: Michael H. Roh; J Pathol Transl Med. 2015;49(4):300-309. Published online June 16, 2015; DOI: https://doi.org/10.4132/jptm.2015.06.16

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Abstract PDF

In this era of precision medicine, our understanding and knowledge of the molecular landscape associated with lung cancer pathogenesis continues to evolve. This information is being increasingly exploited to treat advanced stage lung cancer patients with tailored, targeted therapy. During the management of these patients, minimally invasive procedures to obtain samples for tissue diagnoses are desirable. Cytologic fine-needle aspirates are often utilized for this purpose and are important not only for rendering diagnoses to subtype patients’ lung cancers, but also for ascertaining molecular diagnostic information for treatment purposes. Thus, cytologic fine-needle aspirates must be utilized and triaged judiciously to achieve both objectives. In this review, strategies in utilizing fine-needle aspirates will be discussed in the context of our current understanding of the clinically actionable molecular aberrations underlying non-small cell lung cancer and the molecular assays applied to these samples in order to obtain treatment-relevant molecular diagnostic information.

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Molecular Imaging in the Era of Personalized Medicine: Kyung-Ho Jung, Kyung-Han Lee; J Pathol Transl Med. 2015;49(1):5-12. Published online January 15, 2015; DOI: https://doi.org/10.4132/jptm.2014.10.24

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Abstract PDF

Clinical imaging creates visual representations of the body interior for disease assessment. The role of clinical imaging significantly overlaps with that of pathology, and diagnostic workflows largely depend on both fields. The field of clinical imaging is presently undergoing a radical change through the emergence of a new field called molecular imaging. This new technology, which lies at the intersection between imaging and molecular biology, enables noninvasive visualization of biochemical processes at the molecular level within living bodies. Molecular imaging differs from traditional anatomical imaging in that biomarkers known as imaging probes are used to visualize target molecules-of-interest. This ability opens up exciting new possibilities for applications in oncologic, neurological and cardiovascular diseases. Molecular imaging is expected to make major contributions to personalized medicine by allowing earlier diagnosis and predicting treatment response. The technique is also making a huge impact on pharmaceutical development by optimizing preclinical and clinical tests for new drug candidates. This review will describe the basic principles of molecular imaging and will briefly touch on three examples (from an immense list of new techniques) that may contribute to personalized medicine: receptor imaging, angiogenesis imaging, and apoptosis imaging.

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Case Report

Gastric Adenocarcinoma of Fundic Gland Type: Report of Three Cases: Eun Su Park, Young Eun Kim, Cheol Keun Park, Takashi Yao, Ryoji Kushima, Kyoung-Mee Kim; Korean J Pathol. 2012;46(3):287-291. Published online June 22, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.3.287

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Abstract PDF

Recently, fundic gland type gastric adenocarcinoma (GA-FG) has been reported as a new entity. This report describes GA-FG among Koreans for the first time. From March 2008 to July 2010 we identified only three cases of GA-FG out of over 6,000 GAs resected by endoscopy or surgery. Cell differentiation by mucin proteins, pepsinogen-I, and H+/K+-ATPase was evaluated. All three cases were male patients and diagnosed as early stage GA. Histologically, GA-FGs were well-differentiated adenocarcinoma with pale gray-blue, basophilic columnar or cuboidal cells and mildly enlarged nuclei, resembling chief cells. All three cases were positive for pepsinogen-I and were classified as gastric mucin phenotype. Among three histologic subtypes of GA-FG, since tumors were mainly composed of chief cells, our three cases were classified as chief cell predominant type. In conclusion, GA-FG is very rare among Koreans and pepsinogen-I and MUC6 expression are typical immunohistochemical findings in GA-FG suggesting differentiation toward fundic glands.

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Journal of Gastric Cancer.2024; 24(4): 378. CrossRef
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Original Article

The Ratio of Atypical Ductal Hyperplasia Foci to Core Numbers in Needle Biopsy: A Practical Index Predicting Breast Cancer in Subsequent Excision: Jeong-Ju Lee, Hee Jin Lee, Jun Kang, Jeong-Hyeon Jo, Gyungyub Gong; Korean J Pathol. 2012;46(1):15-21. Published online February 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.15

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Abstract PDF

Background

Although core needle biopsy (CNB) is considered to be the standard technique for histological diagnosis of breast lesions, it is less reliable for diagnosing atypical ductal hyperplasia (ADH). We therefore assessed the characteristics of CNB-diagnosed ADH that are more likely to be associated with more advanced lesions on subsequent surgical excision.

Methods

We retrospectively examined 239 consecutive CNBs, 127 of which were diagnosed as ADH following surgical excision, performed at Asan Medical Center between 1995 and 2010. Archival slides were analyzed for the number of cores per specimen, the number of ADH foci, and the ratio of ADH foci to number of cores (FC ratio).

Results

We found that ADH foci in 3 or more cores (p=0.003) and the presence of ADH in 3 or more foci (p=0.002) were correlated with malignancy following excision lesion. Moreover, an FC>1.1 was significantly associated with malignancy in the subsequent excision (p=0.000).

Conclusions

Including the number of ADH foci, the number of cores involved according to ADH, FC ratio, and histologic type in a pathology report of CNB may help in making clinical decisions about surgical excision.

Citations

Citations to this article as recorded by

Active Surveillance for Atypical Ductal Hyperplasia and Ductal Carcinoma In Situ
Rachel Miceli, Cecilia L Mercado, Osvaldo Hernandez, Chloe Chhor
Journal of Breast Imaging.2023; 5(4): 396. CrossRef

Case Report

Acute Appendicitis Associated with Aspergillosis in a Leukemia Patient: A Case Report.: Bong Hee Park, Jae Hee Suh, Hye Jeong Choi, Hee Jeong Cha, Chang Woo Nam, Young Min Kim; Korean J Pathol. 2010;44(3):330-332.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.330

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Abstract PDF

Herein we describe a rare case of acute appendicitis associated with localized aspergillosis in an 8-year-old boy with acute lymphoblastic leukemia. During chemotherapy, the patient complained of mild abdominal pain in the peri-umbilical area and displayed an increased C-reactive protein level. Abdominal ultrasonography disclosed appendicitis and consequently an appendectomy was done. Histologically, acute appendicitis and Aspergillus hyphae were identified in the lumen and necrotic mucosa. However, there was no evidence of systemic aspergillosis. While aspergillosis is a common fungal infection in immunocompromised patients treated with chemotherapy, acute appendicitis associated with localized aspergillosis without systemic infection is a very rare occurrence.

Citations

Citations to this article as recorded by

A scoping review on acute gastrointestinal surgical complications in immunocompromised pediatric patients
Tarek Bou Dargham, Mohamad Bahij Moumneh, Christine Atallah, Ahmad Zaghal
Annals of Pediatric Surgery.2022;[Epub] CrossRef
Acute isolated Aspergillus appendicitis in pediatric leukemia
Yutaro Yada, Yuhki Koga, Hiroaki Ono, Yoshitomo Motomura, Genshiro Esumi, Kenichi Kohashi, Yasunori Muraosa, Katsuhiko Kamei, Toshiharu Matsuura, Yoshinao Oda, Shouichi Ohga
Journal of Infection and Chemotherapy.2020; 26(11): 1229. CrossRef
Isolated Acute Appendicitis Caused by Aspergillu s in a Patient Who Underwent Lung Transplantation: A Case Report
H.S. Kim, H.J. Yeo, D.H. Shin, W.H. Cho, D. Kim
Transplantation Proceedings.2018; 50(4): 1199. CrossRef
Fungal Appendicitis in Immunocompromised Children. Indications and Contraindications for Laparoscopic Appendectomy: A Report on 2 Successful Cases
Veronica Carlini, Valeria Calcaterra, Nunzia Decembrino, Laura Rubert, Noemi Pasqua, Mattia Novario, Marco Lucioni, Marco Brunero, Gloria Pelizzo
Journal of Pediatric Hematology/Oncology.2016; 38(7): 581. CrossRef
Characteristic clinical features ofAspergillusappendicitis: Case report and literature review
Mihajlo Gjeorgjievski
World Journal of Gastroenterology.2015; 21(44): 12713. CrossRef

Original Articles

Expression of c-fos, p53, Transforming Growth Factor-beta1 and Glial Fibrillary Acidic Protein in Hippocampus Following Transient Forebrain Ischemia in Mongolian Gerbil.: Jae Hwa Lee, Bang Hur; Korean J Pathol. 2001;35(1):60-70.

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Abstract PDF: BACKGROUND
Recent studies have shown that delayed neuronal death is closely associated with early gene (c-fos or c-jun)-related apoptosis in addition to hypoxia-induced energy deficiency in the hippocampus.
METHODS
To elucidate the role of c-fos, p53, TGF-1 and glial fibrillary acidic protein (GFAP) and their interactions, cellular expression with immunohistochemistry was examined during the time period of 10-minute hypoxia with variable reperfusion intervals in the mongolian gerbil hippocampus.
RESULTS
Hippocampal CA1 shows progressive and delayed neuronal damage beginning from the 24-hour reperfusion, while CA2-3 reveals non-progressive, eosinophilic inclusion body within the neuron throughout the time period. CA1 neurons show short-term expressions of c-fos prior to significant cellular damage. However, CA2-3 neurons show persistent expressions by 3-day reperfusion. In both CA1 and CA2-3, p53 is expressed for the short-term period of the early time points. However, its intensity and duration are much less in CA2-3 than in CA1. While TGF-1 is transiently expressed at 24-hour reperfusion in CA1, its expression in CA2-3 is persistent in late time points. Early expression of GFAP is observed in the pyramidal layer of CA1 prior to neuronal damage and progressively increased in the late time points.
CONCLUSION
These results suggest that c-fos and TGF-1 may play a role in neuronal viability in the early- and late time points. Astrocytes may also be responsible for the active protective mechanism to neuronal death, as well as reactive gliosis. The hypoxia-induced neuronal damage is, in part, a p53-dependent process in the CA1 neurons.

Medical Students' Attitudes Toward Autopsy and the Effect of Their Attitudes Following a Forensic Pathology Course.: Yoon Young Yang, Hee Kyung Park, Cheong Yi Park, Won Kee Lee, Sang Han Lee, Jung Sik Kwak, Jong Min Chae; Korean J Pathol. 2004;38(3):165-173.

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Abstract PDF: BACKGROUND
The autopsy is a special surgical operation on a dead body to discover its cause of death. The autopsy is necessary for forensic uses, and it is also of great importance for educating students regarding medical uncertainty.
METHODS
To evaluate medical studentsO attitudes toward autopsy and the effect of their attitudes following a forensic pathology course, a questionnaire with 25 items that addressed the usefulness of autopsies and discomfort reactions was used. One hundred eighty nine medical students from 3 medical schools in Daegu participated in this study.
RESULTS
The medical students showed a high perception of an autopsy's principles, but the medical students were reluctant to become personally involved, despite being more aware of the necessities of the autopsy in forensic cases. Acceptance for the necessities of the autopsy for medical students who took the forensic pathology course was increased, but most of discomfort reactions were not improved.
CONCLUSIONS
One way to fulfill the role of forensic pathology as an inspector for human rights and to retain the very special source of knowledge that autopsies represent would be to provide medical education that lead to reconciliation of the discomfort feelings.

Case Report

Sebaceous Carcinoma Occurred in a Patient with Recurrent Bowen's Disease.: Mi Ok Park, Hoon Kyu Oh, Yong Jin Kim, Jae Bok Park; Korean J Pathol. 1997;31(5):476-481.

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Abstract PDF: Sebaceous carcinoma is a rare malignant epithelial tumor and has diverse clinical presentations as well as a variety of histologic patterns. Although the overwhelming majority of sebaceous carcinomas occur on the eyelid, they may also arise where sebaceous gland and hair are found together, but they favor the head and neck. We report a case of sebaceous carcinoma of the umbilicus in a 68-year-old man who had suffered from a long standing recurrent Bowen's disease of 23 years. The recurrent Bowen's disease in this patient appeared to be closely related to multiple arsenic medication 49 years and 39 years earlier. The excised specimen of umbilicus revealed a well demarcated, 1.5x1 cm sized tumor with grey-yellow hue. The tumor was identified as sebaceous carcinoma, which was characterized by lobular and comedo-carcinoma patterns. The tumor cells showed cytoplasmic foamy vacuolation, nuclear pleomorphism, and high mitotic activity. On an Oil-Red-O stain, the tumor cells were found to contain fine lipid droplets. The intracytoplasmic lipid vacuoles were demonstrated by an electron microscopic examination.

Original Articles

Pathology Teaching for the Undergraduate Students in Korean Medical Schools: Current Debates and Future Program Design.: Yong Il Kim; Korean J Pathol. 2005;39(3):145-150.

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Abstract PDF: This article aimed to summarize the current critiques or debates on the pathology teaching for the undergraduate medical students in Korean medical schools and to rationalize the curricular approaches for renovation and instructional strategies which are under the hot discussion. Of 41 medical schools in Korea, most pathology programs have been criticized along the line of their traditional discipline-oriented, teacher-centered curriculum and morphologydirected instruction by their limited emphasis of developing either the reasoning abilities or the effort for the systematic understanding of disease mechanism, while any measures of compensatory strategies against the declining participation to the autopsy remain unqualified. The formal instruction of the pathology course was also under the strong debates in regard to the driving effort in teaching every corners of the textbook contents aside from the overemphasis of rather monotonous and less dynamic microscopic observation equipped with the sketch-based laboratory works. Also, student's loss of interest on pathology and other concerns neglected during the undergraduate pathology course was discussed. The author stressed the leadership of the pathology course among other biomedical disciplines especially in development of the appropriate educational curricula such as the horizontal vs. vertical integrated teachinglearning process and tutorials. Alternative emphasis was made on more experimental experiences as a part of upgrading the reasoning power together with the simulated case studies prior to the senior class to meet the school objectives.

The Establishment of Hospital Pathology in Korea.: Je G Chi; Korean J Pathol. 1994;28(2):109-117.

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Abstract PDF: A brief historical review of the Pathology Service in the western hospital system in Korea is made. Only since the introduction of western medicine by Japanese officials and American missionaries in the late 1890 has Pathology been considered a major part of basic science in medical schools, and its role as a hospital "Service had previously long been ignored. A limited service of tissue diagnosis of surgical material and autopsy had been performed. Professor Inamato was the first Japanese pathologist to come to Korea and set up a Pathology Department at the Chosun Chongdogbu Hospital in 1913. And Dr Mills appears to be the first American hospital pathologist who worked at Severance Hospital in 1913 doing bacteriology and parasitology as well as lecturing on patology at the medical school. After the Korean war most university hospitals adopted the Central Laboratory system which is equivalent to Pathology Service in the American hospital system. The need for hospital pathologists, therefore increased greatly. To meet this need the Korean Society of Pathologists that was founded in 1946, established a pathology specialty system in 1963, and began to produce hospital pathologists in both anatomic and clinical pathology. Unfortunately in the midst of changing a hospital laboratory system the term Clinical Pathology was erroneously used by some pathologists to measn Hospital Pathology as a whole. They claimed and advocated that Surgical Pathology should also be a part of Clinical Pathology. They made no distinction between anatomic pathology and clinical pathology. Although their claims proved to be erroneous later, the discord between anatomic pathologists and clinical pathologists resulted in a complete separation of the anatomic pathology(AP) and clinical pathology(CP) programs in residency training and in the specialty board system. As of now there is no access to train combined AP and CP specialists who are greatly needed for a great majority of hospitals in Korea. Presently there are almost equal number of anatomic pathology and clinical pathology specialists. M.D. clinical pathologists in Korea have no knowledge of tissue pathology examination, and conversely anatomic pathologists have no access to a clinical laboratory during their training periods. Furthermore there are only a handful specialists in the clinical pathology field. There is an increased chance to have clinical microbiologists, clinical biochemists and other experts in clinical pathology fields, who are not M.D.s but Ph.D.s, in the near future, because M.D. microbiologists and biochemists working at Departments of Microbilogy or Biochemistry at medical schools are doing research of their own. Therefore general clinical pathologists with a con-temporary training background as in Korea would have difficulty in finding a ro as a physician and not as an administrator or supervisor of a clinical laboratory. It is hoped that a balanced system involving Pathology(anatomic pathology) and Laboratory Medicine(clinical pathology) in modern Korean hospitals will be established in the coming years.

Pathologic Analysis of 2159 Cases of Appendix.: Chan Sik Park, Mee Soo Chang, In Ae Park, Yong Il Kim, Gheeyoung Choe; Korean J Pathol. 2000;34(1):39-49.

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Abstract PDF: We reviewed 2159 consecutive cases of surgically resected appendices. The appendectomy specimen consisted of 91 cases of acute focal appendicitis (5.4%), 926 cases of acute suppurative appendicitis (55.1%), 228 cases of acute gangrenous appendicitis (13.6%), 63 cases of periappendicitis (3.8%), 13 cases of pure fibrous obliteration of the lumen (FOL; 0.8%), 18 cases of other diseases (7 mucoceles, 2 mucinous cystic neoplasms, 4 carcinoids, 2 metastatic carcinomas, 2 tuberculous appendicitides, and 1 eosinophilic appendicitis; 1%), and 342 cases with no diagnostic abnormality (20.3%). Patients having acute appendicitis ranged from 3 to 84 years of age, and patients in their 10's and 20's occupied over half of 2159 cases. Diagnostic accuracy of the acute appendicitis was 79.7%. Incidence of the acute appendicitis was suspected to be 7.2/100,000/year. Twenty eight cases of acute appendicitis were associated with diverticula. In the former acute primary diverticulitis led to acute appendicitis in 14 of 28 cases. Among 478 incidental appendectomy cases, there were 3 acute focal appendicitides, 1 acute suppurative appendicitis, 1 eosinophilic appendicitis, 32 periappendicitides, 1 mucocele, 40 pure FOLs, 1 deciduosis, 1 endometriosis, and 1 diverticulosis without inflammation. There were 69 cases of FOL (32 complete forms and 37 incomplete forms), among which 13 cases were associated with acute appendicitis. FOL was more frequent in female patients as well as patients over 40 years of age. Incomplete FOL was considered to progress to complete form with age. The incidence of appendiceal diverticula was higher, whereas the incidences of carcinoid tumor and FOL were lower compared with that in the western report. In 14 of 28 cases the appendiceal diverticulum was the site in which acute appendicitis began.

Case Report

Malignant Mixed Mesodermal Tumors of Ovary: 3 cases report.: Dong Won Kim, Tae Jung Kwon, Dong Wha Lee; Korean J Pathol. 1988;22(2):169-179.

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Abstract PDF: Malignant mixed mesodermal tumor (MMMT) of the ovary is endometrioid tumor containing epithelial and mesenchymal components. The mesenchymal component may be homologous, in which case the term carcinosarcoma is often used, or heterologous, containing cartilage, striated muscle, osteoid, bone, or fat, or combination of these elements. MMMT usually afflicts the postmenopausal woman and occurs more often in the nulliparous female. The disease is usually advanced (stage III) when diagnosed. Cliniopathologic data were presented for 3 cases of MMMT of the ovary with review of literatures. Clinical history substantiated previous reports in postmenopausal women wit this tumor. Symptoms were the same as for ovarian malignancy in general. All the patients presented wit stage II disease, according to the International Federation fo Gynecology and Obstetrics (FIGO) classification. Two patients died of tumor 4 and 10 months after operation, respectively. One patient had been alive at 2 months after operation. None of 3 cases demonstrate evidence of endometriosis in the remaining ovaries. Microscopically, periodic acid-Schiff (PAS)-positive, diastase-resistant hyaline droplets were found frequently in undifferentiated mesenchymal stroma and epithelial structures. The clinical significance and origin of the hyaline droplets in MMMT should be further explored.

Original Articles

The Current Practice of the Autopsy Services and the Autopsy Records at the Seoul National University Hospital.: Jeong Wook Seo, Yoon Sung Lee, Je Geun Chi, Ghee Young Choe, Soong Deok Lee, Chong Jai Kim, In Ae Park, Woo Ho Kim, Ja June Jang, Chul Woo Kim, Seong Hoe Park, Jung Bin Lee, Hyun Soon Lee, Yong Il Kim, Eui Keun Ham, Sang Kook Lee; Korean J Pathol. 1998;32(6):453-459.

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Abstract: This study outlines the current status of the autopsy practice and the medical records for autopsies at the Department of Pathology, Seoul National University Hospital. Total number of autopsy cases from 1954 to 1995 was 3,131. Adults aged over 17 were 371 cases and children were 2,515 cases. The demographic data in 245 cases was not available. The number of adult autopsies and its proportion among total number of autopsies during 10-year periods decreased from 144 cases (40%) during the 10-year-period from 1956 to 52 cases (3%) during the 10-year-period from 1986. The number of children cases during the same period groups increased slightly from 210 cases (58%) to 393 cases (25%). But the number of fetal cases increased rapidly from 7 cases (2%) to 1,146 cases (72%). Among fetal autopsies the proportion of fetuses died earlier than 24 weeks of gestation increased and this figure exceeds that of fetuses that died later than 24 weeks of gestation from 1992. Forty percent of the cases were submitted from the clinical departments of the Seoul National University Hospital but the remainders were referred from 73 hospitals. Final autopsy diagnoses were analysed according to the Korean Standard Classification of Disease (KCD)-3 coding system and by searching key words for all cases. Common diagnoses as coded among cases from 1990 were P9, P0, P2, Q2 and Q0. Common diseases by key words for adult cases were liver disease, tuberculosis and pneumonia. Common diseases for children cases were pneumonia, hyaline membrane disease, meningitis and tuberculosis. Through this study we could show the importance of autopsy services for fetuses. We could also establish a regular registration system for autopsies at general hospitals.

Amniotic Fluid Embolism of Lung: Clinical and histopathological study.: Tae Jung Kwon; Korean J Pathol. 1994;28(6):651-656.

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Abstract PDF: Amniotic fluid embolism is caused by the infusion of amniotic fluid into the maternal circulation with embolization to the lungs during pregnancy, labor or just after delivery. Clinically, this condition combines acute cardiopulmonary failure with a hemorrhagic tendency. We have experienced 11 autopsy cases of amniotic fluid embolism for about 2 years. The most common presenting feature was the postpartum uterine bleeding, followed by shock during oxytocin-induced labor. Histologically, various amount of amniotic debris, among which the most common component was epithelial squames, was demonstrated within the pulmonary vasculatures. In 4 cases, many fibrin thrombi were noted, reflecting the coagulation defect. Masson's trichrome and Alcian blue stains were proven to be valuable to demonstrate the squames and mucin, respectively.

Distribution of Free Radicals in Reperfusion Injury after Transient Brain Ischemia.: Eunkyoung Kwak, Hyungho Suh, Jiyoung Park, Yunsup Kum, Taein Park, Jungwan Kim, Yoonkyung Sohn; Korean J Pathol. 2000;34(11):893-900.

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Abstract PDF: Free radicals are known as an important factor which may act on reperfusion injury after transient or permanent brain ischemia. Numerous studies about cytotoxic function of free radical have been done. Most of these studies demonstrate the function of free radical in reperfusion injury by using radical scavenger or antioxidant as inhibitor of radicals. We used a modification of Karnovsky's Mn2 /diaminobenzidine (DAB) technique to demonstrate intravascular free radicals following transient occlusion and reperfusion of one middle cerebral artery in Sprague-Dawley rats. The MCA was occluded for 2 hours using an intraluminal suture method. The reperfusion time after transient ischemia was 1 hour, 6 hours, and 24 hours, respectively. Animals were perfused transcardially with solution containing Mn2 and DAB. After DAB perfusion, the brains were removed promptly, sectioned in frozen, and stained with methylene blue for light microscopic examination. Upon light microscopic examination, free radicals were confined within intravascular lumen and the amount of deposits increased according to the duration of reperfusion. Upon electron microscopic examination, free radicals were located in nuclear membrane and membrane of mitochondria and RER, and demonstrated as electron dense deposits. In addition, cell processes of the neuron revealed an electron dense deposits beneath the inner side of the membrane. In conclusion, free radicals demonstrated in the reperfusion injury area indicate that free radical acts as an important cytotoxic factor. Intracellular localization of free radicals may explain the relationship between free radical and delayed neuronal injury.

Case Report

Kikuchi's Disease of the Mesenteric Lymph Nodes Presenting as Acute Appendicitis.: Kyueng Whan Min, Ki Seok Jang, Si Hyong Jang, Young Soo Song, Woong Na, Soon Young Song, Seung Sam Paik; Korean J Pathol. 2007;41(1):44-46.

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Abstract PDF: Kikuchi's disease is a benign self-limiting necrotizing lymphadenitis that occurs most commonly in young women, and is usually found in the cervical lymph nodes. When there is an unusual location of involved lymph nodes, the diagnosis can be difficult. We recently treated a patient with Kikuchi's disease who had ileocecal mesenteric lymph node involvement; the patient presented with symptoms of acute appendicitis in an 11-year old boy. Although mesenteric lymph node involvement of Kikuchi's disease is very rare, Kikuchi's disease should be added to the differential diagnosis of acute appendicitis in patients with enlarged ileocecal mesenteric lymph nodes on radiological evaluation.

Original Article

The Pathology Specialty System in Korea: Past, Present and Future Prospects.: Je G Chi; Korean J Pathol. 1992;26(6):537-542.

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Abstract PDF: The specialist system of hospital pathology in Korea has adopted the American system in its start, and divided its categories into anatomical pathology(AP), clinical pathology(CP), and combind anatomic and clinical pathology(AP +CP). Since 1975 the society eliminated the category of combined AP and CP specialist. The first qualifying examination took place in 1963. It started out as a written examination and later changed to have two parts, written and practical. One year of internship and 4 years of anatomic pathology were required for AP specialist. CP required the same period of training in CP to be eligible for the specialist qualifying examination. The training period was shortened to 3 years from 4 years, 1981~1990 and then returned to 4 years in 1991. There has been considerable confusion during the adoption period of the pathologist specialist system in Korea, mainly because of an incorrect concept of the term "clinical pathology" in the modern hospital. Many people understood "clinical pathology" to mean "hospital pathology" as an opposing concept of "basic or experimental pathology" at medical school. The misconception arose from the fact that Pathology Department in a Hospital has not been realized under Japanese hospital system that prevailed Korean hospital system until 1950. In old Japanese style, the laboratory examinations including some histopathological examination had been conduced in corresponding clinical departments. And Pathology Department in medical school was responsible only for autopsy and not for making diagnosis of biopsy or operative specimen necessarily. Therefore, there has been a conflict between traditional Pathologists(most of them anatomic pathologists) at medical school and so-called "clinical pathologists" in the hospital, as the Korean medical delivery system adopted American system particularly after the Korean war. Now in Korean, in the great majority of hospitals, clinical pathology is clearly defined from anatomic pathology, and the two-services are at work in separate programs. However, there are still a few university hospitals, where histopathological examination and reporting are done in the Clinical Pathology Department. It is hoped that a combined AP and CP program can be started again in near future for the pathologists who work in community hospitals or most smaller general hospitals where the pathologists with adequate knowledge on both AP and CP at work supervising clinical laboratory technicians and technologists. However, it is fully realized the specialists in subspecialty field such as neuropathology, dermatopathology, hematopathology, clinical microbiology, clinical chemistry, etc. are also needed. For future prospect both the Korean Society of Pathologists and Korean Society of Clinical Pathologists should collaborate with each other in full scale in spite of painful past experiences.

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