Journal of Pathology and Translational Medicine

Volume 14(2); November 2003

Etcs

Systemic Mycosis in Korea: Yoo Bock Lee; Korean J Cytopathol. 1980;14(2):1-8.

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Abstract: 1877年 actinomycosis가 처음 報告된 이후 1882年에서 1908年 사이에 나머지 深部眞菌性疾患이 거의다 發見되었으나 그後半世紀 동안은 眞菌疾患에 對한 硏究가 등한시되었다. 그 까닭은 첫째로 眞菌性疾患은 稀貴하며 둘째로는 臨床的으로 眞菌症은 表在性皮膚疾患으로 看做되어 왔기 때문이다. 그러던 中 1949年 Gross가 penicillin 投與後에 合倂症으로 口腔內 monilliasis가 發生한 것을 報告한 것을 爲始로 Harris(1950), Hewitt와 Williams(1950) 및 Woods와 Manning(1956) 등이 연달아 化學療法이나 抗生劑投與가 眞菌性疾患을 誘發한다는 것을 主張하게 됨으로서 眞菌症에 對한 證例報告가 急增하였으며 特히 深部組織의 侵犯 및 全身播種의 傾向을 보임에 따라 眞菌性疾患에 對한 關心이 提高되었고 臨床的, 微生物學的 또 病理組織學的意義가 增大되었다(Connant et al. 1954; Lewis et al. 1958, Wilson, 1959; Moss와 MeQuown 1960; Emmons et al. 1977). 眞菌症의 發生頻度가 增加하게 된 理由의 一部는 眞菌症에 對한 認識이 增進된 데 起因한 表面上의 增加를 들 수 있으나 그보다는 細菌性疾患癌腫 및 各種慢性疾患의 治療에 使用하는 抗生物質, 抗癌物質 혹은 steroid 및 免疫抑制劑와 같은 現代醫療에 不可缺한 藥物의 長期間大量投與後에 招來되는 合倂症 또는 交替性感梁으로 因한 絶對的增加인 것으로 보이며 따라서 臨床的 의의가 한층 더 크게 되었다(Hrris 1950; Woods와 Manning 1951; Brown et al. 1953; Craig와 Farber, 1953; Rankin 1953; Bratlund와 Holten, 1954; Levy와 Cohn, 1955; Carpenter, 1955; Schaberg와 Hildes, 1955; Keye와 Magee, 1956; Torack 1952; Steinberg, 1958; O'Donavan, 1957; Hutter, 1959; McBride et al. 1960; Roberts, 1962; Gruhn Sanson, 1963; Emmons et al. 1977). 이러한 事實에 刺戟되어 眞菌疾患에 對한 臨床的實驗的 혹은 病理組織學的硏究가 多角度로 進行되었고 難治病으로 生角되던 眞菌疾患의 治療도 可能한 段階에 이르게 되었다(Palmrose와 Hosli, 1956; Reiman, 1959; Willson, 1959; Emmons 1977).

Changing Pattern and Prospect of Serological Tests for Syphilis: Samuel Y. Lee; Korean J Cytopathol. 1980;14(2):9-14.

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Abstract: 오늘날 우리나라에서 실시되고 있는 종목만 꼽아도 다섯 손가락이 모자라는 것이 이 매독 혈청 반응이다. 또한 환자에 따라 그중에서 골라써야 할 종목이 달라지고, 같은 결과를 가지고도 그 해석이 달라지는 것이 이 매독검사다. 먼저 우리나라에서 현재 쓰이는 종목만 꼽아 보기로 하자. 가장 흔히 쓰는 reagin test에 VDRL slide test가 있다. 이것도 단순히 Reactive와 Non-Reactive로만 구별하는 定性검사와 그 titer까지 결정하는 定性검사가 있다. 비슷한 검사이기는 하나 集團검사에 편리하도록 만든 RPR card test가 있다. 이것도 定性, 定量 모두 할 수 있으나 값이 비싸서 定量에는 쓰기 어렵다. treponemal test로는 FTA-ABS가 수년전부터 연세의료원을 비롯한 몇몇 곳에서 쓰이기 시작하였고 근자에 TPHA가 가톨릭의료원 등에서 새로 시작되었다. 혈청검사는 아니지만 매독진단에 빼지 못할 것이 darkfield microscopy로 treponema 자체를 檢出하는 검사가 있다. 이것까지 합하면 다섯여섯까지 검사를 적절히 取捨선택하여 써야하는 것이 오늘의 현실이다. 本稿에서는 오늘에 이르기까지의 과거도 돌이켜보고 또한 앞으로의 方向도 점쳐 보면서 과연 오늘 우리가 취할 태도가 어떠하여야 할지 매독혈청검사 전반에 대한 검토를 하여 보기로 한다.

A Study on the Mechanism of Generalized Shwartzman Reaction: Soo Young Lee, Won Il Kim, Sung Keun Chang, Choo Soung Kim; Korean J Cytopathol. 1980;14(2):15-20.

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Abstract: The anti-rabbit plasma coagulation factor XIII goat immunoglobulin infusion, prevents the generalized Shwartzman reaction of rabbits elicited by two 24 hours interval intravenous injections of bacterial endotoxin. Measurements of circulating platelets, fibrinogen and factor ?I activities were done after either the first or second injection of endotoxin in both antibody-treated and non-treated rabbits. Twenty four hours after the first injection of endotoxin, a marked increase of platelet was occurred in antibody-treated rabbits, however an increase in fibrinogen was appeared in non-treated ones and forty eight hours after the injection an increase in fibrinogen was greater in antibody-treated group than in non-treated group. Forty eight hours after the first injection of endotoxin, plasma factor ?I activities were decreased in non-treated rabbits. The occurrence of bilateral cortical necrosis was confirmed in four out of five rabbits in non-treated group, whereas no bilateral cortical necrosis was occurred in antibody-treated group.

Cytologic Study on Microinvasive Squamous Cell Carcinoma of the Uterine Cervix: Myoung Hee Kang, Woon Sup Han, Jung Dal Lee; Korean J Cytopathol. 1980;14(2):21-30.

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Abstract: Cervico-vaginal smears from 10 patients with microinvasive squamous cell carcinoma of the cervix confirmed on the histologic examination of the conization or hysterectomy specimen were retrospectively investigated. 1) The degree of stromal penetration on the histologic examination was estimated as upper (1 case), middle (4 cases) and lower 1/3 (5 cases) of the mucosa equivalent to the length of the cervical mucous glands. The cervico-vaginal smears of the 10 patients obtained prior to the surgical interventions were originally diagnosed as severe dysplasia (3 cases), microinvasive carcinoma (2 cases) and invasive carcinoma (5 cases). 2) On the histological examination the covering epithelium of the microinvasive carcinoma showed a variety of intraepithelial neoplastic changes including dysplasia of variable degrees and in situ carcinoma in some extend. 3) A cytologic analysis on the smears revealed the cells indicating microinvasion in 9.5%(upper 1/3), 26.4% (middle 1/3) and 17.8% (lower 1/3 stromal invasion) as a prevalence among the cells screened. 4) The microinvasive carcinoma cells contained cellular abnormalities which varied somewhat in relation to the depth of penetration. The deeper penetrated the abnormal cells the more smeared in aggregates. A tumor diathesis was evident in 9 of 10 ases. The cells with the deepest penetration (lower 1/3) had an irregularly distributed coarse chromatin and prominent nucleoli, while the abnormal cells with upper 1/3 stromal penetration had a regularly distributed fine chromatin and no prominent nucleoli.

Plasmacytosis in the Bone Marrow: K.S. Hahn, I.K. Paik, M.H. Park, H.I. Cho, S.I. Kim; Korean J Cytopathol. 1980;14(2):31-38.

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Abstract: The authors made an analysis on 582 cases of bone marrow Plasmacytosis out of 2,896 cases performed during the last 13 years from 1966 to 1978 at the Department of Laboratory Medicine, Seoul National University Hospital. Cases having 2% or more of plasma cells in differential count were selected, and the results were as follows : 1) The older patients showed the more bone marrow plasmacytosis in general, and this tendency was more prominent in 299 cases of aplastic anemia and 54 cases of Korean hemorrhagic fever. 2) Diseases with prominent bone marrow plasmacytosis other than multiple myeloma in decreasing order of degree were ; aplastic anemia, typhoid fever, hemolytic anemia, Korean hemorrhagic fever, tuberculosis, malignancies with or without bone marrow metastasis, collagen diseases, leukemias (especially acute monocytic and granulocytic), iron deficiency and other types of anemias, liver cirrhosis and idiopathic thrombo- cytopenic purpura. 3) In cases of Korean hemorrhagic fever, the patients in oliguric stage showed more prominent bone marrow plasmacytosis than those in diuretic stage. 4) In aplastic anemia, the patients with bone marrow plasmacytosis showed more prominent hyperglobulinemia than those without plasmacytosis. 5) The incidence of plasmacytic satellitosis was significantly higher in cases having both bone marrow plasmacytosis and serum hyperglobulinemia compared to cases having neither of them. This finding was more Prominent in cases of Korean hemorrhagic fever.

A Study on the Influences of Acid-base Imbalance on the Hematological Pictures of the Peripheral Blood, Bone Marrow and Spleen: Eui Chong Kim, Sang-in Kim; Korean J Cytopathol. 1980;14(2):39-44.

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Abstract: The influences of acid-base imbalance on the hematological aspects of peripheral blood, bone marrow and spleen were studied in albino rats under the controlled environments including room temperature, diet, fluid supply etc. Acidosis and alkalosis were induced by intragastric ingestion of ammonium chloride and sodium bicarbonate, and was confirmed by blood gas analysis including pH and base excess. The results are summerized as follows : 1) The peripheral blood of the acidosis group showed an increasing tendency in RBC, Hb, Hct and reticulocyte count comparing to that of control & alkalosis groups. The WBC total counts were also increased in acidosis group with relative neutrophilia and lymphopenia while the alkalosis group showed marked relative neutropenia and lymphocytosis comparing that of acidosis group. 2) In the bone marrow, the acidosis group showed a decreased erythroid series with increased myeloid series and eosinophilia comparing to the control group. The alkalosis group showed a marked decrease in erythroid series and a marked increase in lymphoid cells comparing to those of control and acidosis groups. 3) In the spleen, the acidosis group showed a marked increase in nucleated red blood cells.

Editorial

Cervical Cancer Screening in Korea.: Moon Hyang Park; Korean J Cytopathol. 2003;14(2):43-52.

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Abstract PDF: The incidence of cervical cancer has been gradually decreased since 1990, now it ranks the fourth most common carcinoma among Korean women in 2001. If squamous cell carcinomas in situ are included, the cervical cancer is still the most frequent tumor in Korean women. However, cervical cancer mortality in Korea has been decreased over the last 10 years in large part attributable to the introduction of the Papanicolaou test (Pap. test). The guidelines for the early detection of cervical cancer recommend women aged 30 and more to take biennial screening with Pap. test. According to the screening data of National Health Insurance Corporation (NHIC), 4,425 women (0.94%) showed an abnormal Pap among 473,395 cases tested in 2001; dysplasia was in 3,953 (0.84%) women, in situ carcinoma in 357 (0.075%) women, and invasive carcinoma in 115 (0.024%) women. The detection rates of abnormal Pap. were 4.21% in Korean Society for Cytopathology (KSC-2001), 1.37% (ASCUS : 0.26%, AGUS : 0.03%, LSIL : 0.45%, HSIL : 0.55%, Carcinoma : 0.09%) in health check-up and 5.41% (ASCUS : 1.89%, AGUS : 0.69%, LSIL : 1.39%, HSIL : 0.84%, Carcinoma : 0.64%) of patients in out-patient clinic without having history of cervical neoplasia at Hanyang University Hospital in 2002. Low rate of cervical cancer screening (34%) in Korea is mainly due to the lack of information for the low income people regarding national cancer screening program. More adequate budget by government and more man-power for precise screening, new guideline and system for management of the cervical cancer patients are required.

Etc

A Study on Serum Ferritin Level in Iron Deficiency Anemia: Yoon Chung Kim, Kui Nyung Yi, Samuel Y. Lee; Korean J Cytopathol. 1980;14(2):45-51.

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Abstract: The recently developed method of measuring serum ferritin by using radioisotope has assumed a very important role in the diagnosis of iron deficiency anemia. The serum ferritin level of a patient with iron deficiency anemia (I.D.A.) is very low, compared to that of normal person. While, the patients with anemias other than I.D.A. and some kinds of diseases may reveal elevated serum ferritin level. Author measured serum ferritin level by using two-site immunoradiometric assay, serum iron, total iron binding capacity from which the transferrin saturation is determined by using modified Goodwin method on 24 patients confirmed to have I.D.A. and normal controls comprised of healthy 66 males and 60 females. The results are summarized as follows. 1) The average serum ferritin, iron level, and transferrin saturation of male controls were 63.8ng/ml, 103.2㎍/100ml, 32.8%, and those of female controls were 20.3ng/ml, 68.3㎍/100ml, 24.2%, respectively. 2) The average serum ferritin, iron level, and transferrin saturation of patients with I.D.A. were 9.1ng/ml, 97.3㎍/100m1, 16.2% and these values were lower than those of normal healthy controls. 3) The finding of bone marrow iron was closely correlated with serum ferritin level and transferrin saturation, but not so well with serum iron level. 4) Serum ferritin level and transferrin saturation of the patients with I.D.A. were significantly lower than those of normal controls (p<0.05), but the serum iron level did not show a significant difference from that of normal controls (p>0.05). From above results, it can be said that single measurements of serum iron or T.I.B.C. could hardly help the diagnosis of I.D.A. So the two factors should be measured at the same time for the determination of transferrin saturation. But, the transferrin saturation can hardly indicate the presence of I.D.A. in some cases. The measurement of serum ferritin is relatively simple and often useful for the diagnosis and follow-up of treatment of I.D.A. When some I.D.A. patients show normal serum ferritin levels, bone marrow examination should be indicated for the exact diagnosis.

Original Article

Diagnostic Correlation and Accuracy Between Fine Needle Aspiration Cytology and Histopathologic Examination.: Jin Hee Sohn, Seoung Wan Chae, Eun Yoon Cho, Eo Jin Kim; Korean J Cytopathol. 2003;14(2):53-59.

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Abstract PDF: Fine needle aspiration cytology (FNAC) has been known as a very sensitive and effective method for preoperative diagnosis. We studied cases preoperatively diagnosed by FNAC and confirmed by the histopathologic examination to define the effectiveness of FNAC. A total of 567 cases including breast, thyroid gland, lymph node, and soft tissue confirmed histologically after FNAC were enrolled, among 2,844 FNAC cases from January 1996 to March 2000. Overall sensitivity and specificity of FNAC were 93% and 100%, respectively. Sensitivity and specificity of FNAC by sites or organs were 91% and 100% in breast, 100% and 100% in thyroid, 97% and 100% in lymph node, and 71% and 100% in soft tissue, respectively. Nine cases showed diagnostic discrepancy; eight cases of sampling error and one case of interpretation error. Five cases, diagnosed as fibrocystic change at FNAC but invasive ductal carcinoma after the histopathologic examination, were categorized as sampling error due to the presence of diffuse fibrosis or deep seated location. One case of breast, diagnosed descriptively as atypical ductal and stromal cells suggesting invasive ductal carcinoma at FNAC but malignant phyllodes tumor histologically, was categorized as interpretation error. Other cases of sampling errors were two cases of soft tissue, a case of lymph node, and a case of salivary gland.

Etc

Effect of Improved Method of Cultivation on the Isolation of Anaerobic Bacteria: Hyon-Suk Kim, Yunsop Chong, Samuel Y. Lee; Korean J Cytopathol. 1980;14(2):53-59.

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Abstract: In order to improve the isolation of anaerobic bacteria from clinical materials, we have been using Stuart transport medium to hold swab specimens and phenylethanol blood agar to inoculate specimens since 1978. Also, all purulent materials have been cultured anaerobically regardless of the request. To evaluate the effect of such a practice, an analysis was made on the data obtained during the period of September 1978 to August 1979. The following results were obtained. 1) A total of 256 positive cultures of anaerobic bacteria were isolated from 187 patients. Of these 87 were gram-positive cocci and 143 gram-negative bacilli. 2) Anaerobes were most frequently isolated from specimens of abdominal, head and neck, and genital lesions. 3) The percentage of the number of specimens with both anaerobes and aerobes from the same specimen against the total isolation of anaerobes has increased from 41.4% in 1975-77 to 77.5% in 1978-79. 4) The percentage of anaerobe isolations against the total number of bacteriological specimens was 0.48% in 1975-77 and 1.34% in 1978-79. 5) The percentage of Clostridium against the total number of anaerobe isolates was 18% in 1972-73 and 3.1% in 1978-79. These facts clearly indicated that our new measures taken in 1978-79 have resulted in favorable effects in the isolation of non-sporeforming anaerobic bacteria from clinical specimens.

Original Article

Sensitivity of AutoPap Primary Screening System with Location-Guided Screening in Uterine Cervical Cytology.: Jong Sun Choi, Hoi Sook Jang, Hy Sook Kim, Yi Kyeong Chun, Hye Sun Kim, Ji Young Park, In Sou Park, Sung Ran Hong; Korean J Cytopathol. 2003;14(2):60-65.

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Abstract PDF: OBJECTIVE: The sensitivity of the AutoPap Primary Screening System with Location-Guided Screening (AutoPap LGS) for identifying atypical cells in cervicovaginal smears was evaluated. METHODS: Two hundred forty one slides with atypical cervical cytology randomly sampled were rescreened both manually and by the AutoPap LGS. The AutoPap LGS localized the atypical cells as 15 fields of view(FOVs), which were reexamined by manual review. The sensitivity was also evaluated in accordance with the cellularity of the smears. RESULTS: The AutoPap LGS successfully processed 232 out of 241 slides. The sensitivity of the AutoPap LGS identifying the atypical cells in successfully processed slides was 97.4%(226/232). The false negative rate was 2.6%(6/232). There was no false negative case in high grade squamous intraepithelial lesion (HSIL) or squamous cell carcinoma(SCC) smears in the AutoPap LGS. The FOVs localized the diagnostic-atypical cells in 97.8%(221/226). The number of diagnostic-atypical FOVs was increased in higher-degree of atypical cytology. The AutoPap LGS localized the atypical cells in 100% of adequately cellular smears and in 92.5% even in low cellular smears. CONCLUSION: The AutoPap LGS showed relatively good sensitivity to detect atypical cells. It can be a valuable system to localize atypical cells, especially in HSIL or cancer slides, even in smears with low cellularity.

Etc

Study on Sex Differention by Leukocytic Nuclear Appendages in Peripheral Blood of Korean: Kyu Man Lee, Eui Keun Ham; Korean J Cytopathol. 1980;14(2):61-68.

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Abstract: A study on sex difference by nuclear appendages of polymorphonuclear neutrophilic leukocytes was made of one hundred cases in equal numbers of Korean male and female using peripheral blood smears. The nuclear appendages were observed and morphologically classified into type A (drumstick body), type B (sessile nodule, nodule with a thick stalk, drop), type C (rod, hocky, filament) and type D (dome, pyramid, rectangle) and made to differential counting of each type in the 500 neutrophils. Followings are results : 1) The occurrence of nuclear appendage type A was 5±3.8 in female, whereas no one was observed in male at all. It seems type A was the absolute diagnostic criteria for sex differentiation. 2) The occurrence of nuclear appendage type B was 46±18.8 in male, 55±26.3 in female, type C, 77±24.8 in male, 44±19.5 in female and type D, 55±16.2 in male, 47± 19.7 in female. The combined occurrence of type A and B was 46±20 in male and 61± 27.5 in female, All of them revealed no recognizable significance to make sex difference. 3) The ratio of the occurrence of type A and B to that of type C was 0.6±0.1 in male and 1.5±0.6 in female respectively and that was considerably significant to make sex difference. 4) The ratio of the occurrence of type A, B and D to that of type C was 1.4±0.3 in male and 2.7±1.0 in female respectively, and the ratio of the occurrence of type A and B to that of type C and D was 0.4±O.1 in male and 0.7土0.2 in female respectively, those were helpful to make sex differentiation.

Case Report

Cytologic Features of Signet Ring Cell Carcinoma of the Uterine Cervix: A Report of Two Cases.: Hyun Yee Cho, Seung Yeon Ha, Jaegul Chung, Young Ha Oh, Dong Hae Chung, Na Rae Kim, Jong Min Lee, Eui Don Lee; Korean J Cytopathol. 2003;14(2):66-70.

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Abstract PDF: Signet ring cell carcinoma is a rare type of mucinous adenocarcinoma of the uterine cervix. To the best of our knowledge, there is no report on cytologic findings of primary signet ring cell carcinoma of the uterine cervix in the literature. Recently, we experienced two cases of signet ring cell carcinoma of the uterine cervix. The finding of characteristic signet ring cells on cervicovaginal smear led to the diagnosis of signet ring cell carcinoma. However, primary signet ring cell carcinoma could not be cytologically distinguished from more common metastatic tumor. Therefore, diagnosis rests upon the recognition of signet ring cells and the absence of signet ring cell carcinoma elsewhere.

Etc

Changes on Serum Protein Fraction and Serum Immunoglobulin in Liver Diseases: Bock Hee Park, Soon Ho Kim; Korean J Cytopathol. 1980;14(2):69-79.

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Abstract: The author investigated changes of serum protein fractions and immunoglobulins in 46t cases of patients with various liver diseases who had been visited or admitted to he Department of Insternal Medicine, Busan National University Hospital and 20 cases of control subjects from May, 1979 to March, Jul 1980. The 46 cases of liver diseases were consisted of 13 cases of acute hepatitis. 13 cases of chronic hepatitis, 13 cases of liver cirrhosis and 7 cases of hepatocellular carcinoma, Diagnosis was confirmed clinically and histopathologically in all the patients. Serum protein fractions were measured by cellulose acetate electrophoresis and serum immunoglobulins were measured by radial single immunodiffusion method. The results obtained were summerized as follows : 1) In the acute hepatitis, the levels of alpha globulin, gamma-globulin, IgG and IgM were significantly increased than those of control. 2) In the chronic hepatitis, the levels of serum albumin was significantly decreased than that of control and acute hepatitis. The levels of gamma-globulin, IgG and IgM were significantly increased than those of the control. The level of IgA was significantly increased than that of the control and acute hapatitis. 3) In the liver cirrhosis, the level of albumin were significantly decreased than that of the control, acute hepatitis and chronic hepatitis. The level of gamma-globulin, IgG and IgM were significantly increased than those of the control. The level of IgA was significantly increased than that of the control and acute hepatitis. 4) In the hapatocellular carcinoma, the level of albumin was significantly decreased than that of the control and acute hepatitis. The level of alpha-globulin was significantly increased than that of the control, chronic hepatitis and liver cirrhosis. The levels of gamma-globulin and IgM significantly increased than those of the control and level of IgA was also significantly increased than that of the control and acute hepatitis.

Case Report

Uterine Tumor Resembling Ovarian Sex-Cord Tumor: A Case Report of the Cytologic Finding.: Insun Kim, Eun Mee Han, Woon Yong Jung, Ju Han Lee, Bum Woo Yeom; Korean J Cytopathol. 2003;14(2):71-75.

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Abstract PDF: Uterine stromal tumors with features of ovarian sex-cord differentiation are relatively rare. The neoplasms composed of sex cord-like components in more than 50% of the tumor are classified as group II. We report the cytologic findings of a case of uterine tumor resembling ovarian sex-cord tumor. The cervical smears of a 62-year-old woman with submucosal tumor showed loose aggregates of spindle cells as well as glandular or tubular structures of round cells with a distinct cell membrane and a prominent small nucleolus. Because uterine stromal tumor can have sex cord differentiation, its possibility should be considered in the interpretation of cervical smears.

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