Journal of Pathology and Translational Medicine

Volume 14(1); April 1980

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Clinico-Pathologic Studies on Testicular Tumors among Koreans: Myoung Hee Park; Korean J Pathol. 1980;14(1):1-11.

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Abstract: Though the tumors of the testis comprises only a small percentages of all human malignancy, they unfortunately strike the young and productive men with greatest frequency. No other organs, except the ovary, manifest the wide structural range of neoplasia and the broad spectrum of clinical behavior as these encountered in the testis. There have been very little comprehensive studies on the testicular tumors among Koreans. The present study is, therefore, intended to establish a basic pathologic and clinical aspect of the testicular tumors among Koreans. The author collected sixty Veight cases from sixty six patients in four medical centers to get a wider statistical study. The majority were 50 cases from Yonsei University Hospital and 9 from Ewha Womans University Hospital during the twenty years from July, 1959 to June, 1979. Five cases from Korea General Hospital during the eleven years from July, 1968 to June, 1979, and 4 cases from Paik Hospital during the five years from July, 1974 to June, 1979 were added. The microscopic observations were made on the routine hematoxylin and eosin stained sections. Age, laterality, chief complaints and symptom duration were investigated when clinical informations were available. The results were as follow: 1. According to the histologic types, embryonal carcinoma was 17 cases (25.0%), seminoma, 15(22.1%), teratoma, 12(17.6%), yolk sac tumor and mixed germ cell tumor, 7(10.3%), respectively, and gonadoblastoma, 1(1.5%). Malignant lymphoma was 7cases (10.3%) and rhabdomyosarcoma, 2(2.9%). Among 15 cases of seminoma, classical type was 13 and anaplastic type, 2. Among 12 cases of teratoma, 9 were mature and 3 were immature. 2. Among symptoms, a painless palpable scrotal mass was most frequent which were 13 out of 34 cases. The duration of the symptom was less than 6 months in 12 cases (36.3%) and over 2 years in 7 cases (21.2%). 3. The tumors were developed almost equally in each testis. Four patients had bilateral tumors and among them, two had two different histologic types. Six cases were occurred in the undescended testes. 4. Twenty-four patients (35.3%) were in the first decade and the mean was 22 years, while it was 35.6 years in seminoma, 15.4 years in embryonal carcinoma, 12.7 years in teratoma, 2.4 years in yolk sac tumor and 42.7 years in malignant lymphoma. 5. Twenty four patients (73.0%) out of 33 cases whose clinical records about treatment were known, received orchidectomy only.

Studies on Serum Immunoglobulin Patterns in Liver Diseases: Ae Ja Park, Suh Hae Kim, Kyung Soon Song, Kyi Nyong Yi, Samuel Y. Lee; Korean J Pathol. 1980;14(1):13-24.

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Abstract: The recent development in immunology have facilitated the study of the immunological aspects of acute and chronic liver disease which are frequently associated with changes in serum immunoglobulin levels. After thatemphasized values of serum immuno globulin assay in the diagnosis of primary disease of the liver by Hobbs (1967), these changes, are often characteristic of the individual disease and may therefore help in their differentiation and provide evidences as to the pathogenesis. At the department of clinical pathology, Yonsei University Medical College, using the Laser-Nephelometry (Model PDQ, Hyland Labolatories, Costa Mesa, calif.) the rapid and accurate measurement of serum immunoglobulin has been made. 101 cases of acute and chronic liver disease were observed. Control sera were obtained from 51 healthy adult Korean. Serum immunoglobulin levels were measured by the Laser-Nophelometry, using monospecific antisera obtained from Hyland manufacture. The results are as the follows. 1) The mean±2S.D. values of Ig G, Ig A, Ig M in adult healthy Korean were 1364± 362mg%, 378±145mg%, and 127±54mg %, respectively. The more age, the higher the levels of immunolobulin in sera, except third decade of female. 2) In the case of the acute hepatitis, the levels of Ig M were significantly increased in the both HBs Ag negative and HBs Ag positive group, while the levels of Ig G were increased in the cases of the HBs Ag positive group, which provided the valuable differential point between the 2 types of the acute hepatitis. 3) In the case of HBs Ag negative group, Ig M were significantly in creasedon the first week, Ig G and Ig A on the second week and to the normal levels on the 8th week after the onset of the symptoms. In contrast in the cases of HBs Ag positive group, IgM is increased on the second week and then decreased to the normal level at the 12th week-persisting longer than HBs Ag negative group-lt is important test that the measurement of different Classes of serum immunoglobulin to observe the course of acute viral hepatitis. 4) Serum Ig G levels are higher than control group in all cases, but not cases of acute HBs Ag negative hepatitis and metastatic cancer. Especially Ig G is increased in 90.5% of postnecrotic cirrhosis, and 78.6% of primary hepatocellutar carcinoma. 5) Serum Ig A levels are higher than control group in all cases, but not in cases of primary biliary cirrhosis. Especially Ig A levels are increases more two times than the control, in cases of liver abscess and metastatic carcinoma of the liver. 6) Serum Is M levels are higher in all liver diseases except in cases of hepatic carcinoma. Especially Ig M levels are increased in cases of primary biliary cirrhosis. No single test can answer the many complex questions that beset the clinician confronted with problems in liver diseases, but the importance of IgA in the diagnosis of amebic abscess, of IgM in the diagnosis of primary biliary cirrhosis is supported by the present data.

A Comparative Study of Frozen, Permanent Sections of Gastroscopic Biopsy and Gastrectomized Specimen: Jong Eun Joo, Il Hyang Ko; Korean J Pathol. 1980;14(1):25-30.

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Abstract: This study was carried out to estimate reliability of frozen section against permanent preparation in gastric biopsies and all biopsies and all biopsies against gastrectomized specimnse. From July, 1977 to June, 1979, 667 cases were biopsied at Seoul Paik Hospital, In Je Medical College. Out of 667 cases, frozen section was performed in 575 cases in addition to permanent tissue preparation. From each biopsied material, one to four sections were made either for frozen or permanent preparations. In this series, 107 cases were gastrectomized of which 80 cases were proven to be carcinoma and 27 cases were non-malignant lesions. The correspondence of frozen section with permanent preparation of gastric biopsy was 85.7%, while 77.6% of permanent preparation of gastric biopsy corresponded with final diagnosis of gastrectomized specimens. 12 out of 107 gastrectomized patients revealed early carcinoma, of which 11 cases were detected by the biopsies, only one missed. The detect-ability will increase if endoscopist can properly select the biopsy site. The authors also wish to stress secondary benefit of making both frozen and permanent sections because of chances of studying sections at different layers of the tissue at different directious.

A Comparative Study on the Detection Rate of HBsAg according to Various Methods: Woo Sung Ahn, In Ki Paik, Sang In Kim; Korean J Pathol. 1980;14(1):31-37.

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Abstract: A comparative study on the detection rate of HBsAg according to various methods; enzyme immunoassay, indirect hemagglutination, reverse passive hemagglutination and counterelectrophoresis methods. Study subjects consist of 289 hospital patient samples requested for HBsAg tests, 146 hospital personnel Seoul National University Hospital and 397 pupils from an elementary school in Kangwondo. The sensitivity and specificity of these methods were also evaluated using 100 HBsAg positive samples confirmed by radioimmunoassay. The results are summarized as follows; 1) The HBsAg positive cases in 289 patients were 64 (22.1%) by EIA, 63 (21.8%) by IHA, 61 (21.1%) by RPHA, 12 (4.2%) by CEP. 2) Of the 146 hospital personnel of SNUH, only 2 persons were HBsAg positive by four methods. 3) The HBsAg positive cases in 397 pupils of an elementary schcol were 46 (11.6%) by IHA, 42 (10.6%) by RPHA. 4) Of the 100 HBsAg positive samples confirmed by RIA, 100 by EIA, 99 by IHA, 96 by RPHA and 25 by CEP were positive. 5) Of the 200 HBsAg negative samples confirmed by RIA, none were positive by the four methods.

Transient Appearance of a Plasmocytogenic Area in the Follicle of Bursa Fabricus After Whole Body Radiation: Sun Moo Kim; Korean J Pathol. 1980;14(1):39-46.

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Abstract: The Bursa Fabricus and the thymus so similar that both of them are called central immune organs from the functional view point or lymphoepithelial organs from the morphological view point. Their reponses to various injuries are also similar. Kim and colleagues studied the origin of plasmocytes under various experimental conditions and confirmed that a strong transient plasmocytogensis appeared in the thymus of rats after whole body X-ray radiation. So, the author attempted to confirm whether plasmocytogenesis could be induced in Bursa Fabricus of chickens by whole body radiation or not. As a result, the author confirmed a strong transient plasmocytogenesis in the follicle of Bursa Fabricus 24 hours after 400 R-whole body radiation. In the normal follicle of Bursa Fabricus, there is no plasmocytogensis. However, massive destruction of small lymphocytes took place in the follicle after X-ray radiation, followed by a transient plasmocytogenesis, which preceded regeneration of small lymphocytes.

Histological Distinction between Primary Lymphoma and Leukemic Infiltration of Lymph nodes: Ae Seek Kim, Je G. Chi; Korean J Pathol. 1980;14(1):47-54.

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Abstract: The pathologist faced with the necessity for examining the lymph node biopsy needs certain criteria for the differentiation between primary malignant lymphoma and secondary leukemic infiltration into the lymph node. The distinction is not only of academic interest but also has a practical importance because the management of patient with these two diseases is different. Authors conducted a morphological study on 24 lymph nodes that were diagnosed either as lymphnode involvement by lymphogenous leukemia (Group I ). malignant lymphoma of poorly differentiated lymphocytic type (Group II ) or These lymph node specimens were obtained during a period of 10 years from January 1970 to December 1979 at the Department of Pathology of Seoul National University Hospital. The distinction between two groups was made by clinical and hematological findings. To evaluate these lymph nodes ten items were set beforehand, and the results were tabulated (Table I). In summary there was not a single histological feature that would distinguish these two groups of disease. However, combining the various features listed in table I we could reasonably besure of differentiating one from the other. Reviewing the useful histological findings, paucity of mitosis, monotonous tumor cell population in lymph node with involvement of intranodal veins and infiltrating features suggestive of Indian file, were particularly prominent in leukemic infiltration of lymph nodes as compared to lymph nodes involved by primary malignant lymphoma.

A Study of Nosocomial Infection -hospital environment-: Young Kee Kim, Myung Hee Park, Sang In Kim; Korean J Pathol. 1980;14(1):55-59.

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Abstract: In recent years the nosocomial infection has been important in hospital administration, preventive medicine and patient's treatment. The author studied several aspects of hospital environment in Seoul National University Hospital from February to September 1979, and the results are as follows: 1) Periodical 3 consecutive examinations of rectal swabs of 63 food service employees were all negative for enteropathogenic organisms including Salmonella and Shigella. 2) HBsAg tests were done for 96 laboratory technicians and 50 central service employees and positive results were observed in 2 laboratory technicians. 3) Periodical biological monitoring of sterilizers was done, using commercial bacterial spore strips. Positive culture was obtained in 2 out of 51 tests for 3 Steam sterilizers and in 4 out of 14 tests for one ethylene oxide gas sterilizer. 4) Product sampling and culture were done for 7 kinds of commercial infusion fluids, 2 kinds of disinfectants and 14 sets of various operation Packages or dressing materials and positive culture was obtained in one disinfectant. 5) Air sampling was done in multiple strategic areas by exposing Standard Petri dishes for 5 minutes. The mean colony count was 8.8±7.8 (1 S.D.) particles/plate/5min.

Congenital Cystic Adenomatoid Malformation of the Lung: Myoung Hee Park, Young Jin Kim, Jung Sil Cho, Ok Kyung Kim; Korean J Pathol. 1980;14(1):61-64.

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Abstract: Congenital cystic adenomatoid malformatlon (CCAM) of the lung is a rate, potentially lethal form of congenital pulmonary cystic disease and was introduced in the English literature by Chin and Tang in 1949. According to Daroca (1979), there have been approximately 70 cases reported In the world's literature up to 1979. Recently we have experienced a case of CCAM from a 2,880 gm female infant, who was born by a matter of G4P2 with repeated cesarian section at 37 weeks. The infant appeared normal at birth, but 4 hours later cyanosis was developed. On physical examination, markedly decreased breath sound at the left chest with coarse breath sound at the right chest was noted. Chest roentgenogram revealed a large round cavity filling the left lower hemithorax with increased radiolucency and displacing the heart and mediastinum to the right. By varium study, diaphragmatic hernia was excluded. Because of no improvement in symptoms and findings, left lower olobectomy with open thoracotomy was performed at 3 days of age under the diagnosis of congenital lung cyst. No main bronchial or vascular anomalies were seen. The resected specimen was enlarged, spongic d purplish lung weighing around 50gm. The lung was largely replaced by a large and many small cystic spaces traversed by remaining collapsed parenchyme on cut sections. The largest space measure about 4cm in diameter and the inner surface was not smooth. The peripheral portion of the specimen were rather atelectatic and seemed to be uninvolved. The microscopic finding is characterized by numerous cystic spaces that are lined by bronchial type epithelium, and gland-like spaces or alveolar spaces that are lined by simple cuboidal or columnar epithelium with occasional mucus producing cells. Bronchial seromucinous glands and cartilages are totally lacking. One day after operation, the patient expired. CCAM occurs in premature infants or still borns in many instances, but rarely in new-borns and older children. Operation should be performed as soon as the diagnosis is established, because it is a surgically curable condition.

Angiosarcoma of the Breasts -A report of a case-: Sung Sim Kim, Chong Moo Lee; Korean J Pathol. 1980;14(1):65-68.

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Abstract: Primary angiosarcoma of the breast occurring usually in young women is a rare but distinctive clinical and pathologic entity. It is an extremely aggressive tumor usually with unfavorable prognosis which exhibits recurrences and hematogenous metastases. In August, 1977, we experienced a case of angliosarcoma of the right breast in 33 year old woman who had a progressively enlarged, palpable mass in the inner upper quadrant of the breast. Clinical data and histopathological findings of this case were discussed with a brief review of literature on this entity.

Aeromonas hydrophila Infections: Young Sook Choi, Yunsup Chong, Samuel Y. Lee; Korean J Pathol. 1980;14(1):69-74.

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Abstract: A water inhabiting gram-negative bacillus, Aeromonas hydrophila has long been considered to be a saprophytic organism, nothing to do with human infections. But there is an increasing evidence that this organism does cause human infections, some of which are quite serious ones. Most of the infections have some relationship with water contaminations. Many of the patients have some underlying conditions such as hepatobiliary disease and various malignancies. During a 16 month period of time from May 1977 to August 1578, the authors isolated A. hydrophila from 15 different patients. Out of these 15 cases, an analysis of both clinical and laboratory data was made on 13 patients. The results are as follows: 1) Most of the patients were 17- to 29-year-old males, a group who are prone to suffer injury due to their activity. 2) Most of the cultures were isolated from wounds of extremities which is the site easily contanmined with water or soil. Specimens also included blood, bile, and peritoneal fluid. 3) The patients had underlying conditions such as open wound, burn, carcinoma, leukemia or hepatitis. 4) From 8 of the 13 patients other species of bacteria were also isolated. All of them were gram-negative bacilli except 1 culture of S. aureus. 5) All of the isolates were susceptible to chloramphenicol, and gentamicin, but most of them were resistant to ampicillin and to cephalothin by kirby-Bauer method. 6) Five out of the 13 patients died. The causes of death were thought to be: septicemia, 4 and hemothorax, 1. Etiologic agent of 2 out of the 4 septicemias were proven to be A. hydrophila, bacterilogically. From this study it is concluded that A. hydrophila infection is not rare and the infection include severe ones. To select proper antibiotics for the treatment, correct identification of the infection was considered necessary.

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