Oral verruciform xanthoma (OVX) is an uncommon benign lesion of the oral mucosa, clinically mimicking various verrucous lesions. This study aimed to describe the clinicopathological characteristics of OVX. Twenty-one patients diagnosed with OVX were collected. The patients’ age, sex, medical history, clinical features, and treatment were reviewed. Archived slides were reviewed, and periodic acid-Schiff (PAS) and immunohistochemical (IHC) staining with CD68, CD1a, and S-100 were performed. OVXs affected 13 males and 8 females (M: F=1.6:1) with a mean age of 52 ± 21 years. The most prevalent site was the gingiva (57.1%), followed by the hard palate (28.5%). The lesions presented as an asymptomatic solitary lesion with verrucous or granular surface, with exception of one case with multiple papules on the hard palate. PAS-positive granules were found in xanthoma cells in 14 (66%) specimens. IHC revealed that xanthoma cells were positive for CD68 and negative for CD1a and S-100 in all specimens. Most lesions were successfully excised, and none of the lesions have recurred. Clinicians should include OVX in the differential diagnosis of various verrucous lesions in the oral cavity to provide appropriate management.

The Department of Oral and Maxillofacial Pathology was established in March 1970 by Dr. Young Pill Cho. Successive chairpersons of the department have included Dr. Han Kook Cho, Dr. Jaeo Cho, Dr. Eun Chull Kim, and Dr. Sang Wook Kang, who held the position until 2021. The tasks of the Department of Oral Pathology include conducting lectures and laboratory work for undergraduate dental students, as well as for graduate students pursuing MSD and PhD degrees. The department also engages in research within the field of oral pathology and provides diagnostic services for tissues obtained from diseases affecting the oral and maxillofacial regions. The objectives of the department are to equip students with the appropriate knowledge and skills to diagnose and develop accurate treatment plans for diseases affecting oral and maxillofacial structures through lectures and laboratory work after graduation. Since the establishment of the Master's and PhD programs in Oral and Maxillofacial Pathology, a total of 94 individuals have completed the Master's program, 45 individuals have completed the PhD program, and 1 individual has completed the Master-PhD collaboration program. Each participant completed their respective courses and obtained the appropriate degrees following the evaluation of their graduation theses.

Among pancreatic cystic lesions, mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN) of the pancreas are precursor lesions of pancreatic adenocarcinoma. IPMN is characterized by intraductal papillary proliferation of mucin-producing epithelial cells that exhibit various degrees of dysplasia. IPMN is classified as the main duct type (MD-IPMN), mixed type and the branch duct type (BD-IPMN) according to the location of involvement, and into four histological subtypes (gastric, intestinal, pancreatobiliary, and oncocytic) according to the histomorphological and immunohistochemical characteristics. Most patients with MD-IPMN undergo tumor resection due to moderate to high risk of malignancy. Patients with BD-IPMN who do not undergo resection may develop malignant change, and concomitant separate pancreatic cancer occurs in 2-10% of patients with IPMN. Patients with BD-IPMN who do not undergo resection should do careful surveillance including endoscopic ultrasound sonography for the early detection of malignant change and separate pancreatic cancer.

Background/Aim: In gallbladder cancer (GBC), gender differences in incidence and mortality rates have been reported with geographic variation. However, there is little known about sex-related difference in GBC prognosis. This study compares prognostic factors according to gender for GBC. Methods: We searched clinicopathological factors in all stages of 952 GBC patients from seven medical centers in Korea. A total of 927 patients were enrolled and surgery with curative resection was performed in 499 patients. Results: Carbohydrate antigen (≥37 U/mL) was a significant prognostic factor in both females and males (odd ratio [OR], 4.30; 95% confidence interval [CI], 3.13-5.89; p<0.001). Age was a significant factor only in female patients, elderly patients were associated with low resectability and the likelihood of T-stage >2; an independent predictor of poor prognosis via multivariate analysis (OR, 1.03; 95% CI, 1.01-1.05; p=0.005, OR, 1.05; 95% CI, 1.02-1.08; p=0.002). Body mass index (BMI) also showed gender difference, and lower BMI (≤25 kg/m2) was the significant good indicator of multivariate analysis for lymph node metastasis in female patients (OR, 0.42; 95% CI, 0.23-0.77; p=0.005) but, the significant poor indicator of univariate analysis for advanced T-stage in male (OR, 2.79; 95% CI, 1.40-5.54; p=0.003). Conclusions: These results suggest that there is a possibility of gender difference in GBC prognosis. Age and high BMI were poor prognostic factors for curative resection for female GBC patients.

Recently, as the level of treatment at animal hospitals has improved, there has been tremendous growth in the number and types of laboratory tests for accurate diagnosis. Laboratory testing is critical for disease diagnosis, follow-up, and appropriate treatment implementation in veterinary hospitals. It occupies an important aspect not only in the diagnostic aspect but also in the income of hospitals. Accordingly, the role of veterinary nurse in conducting clinical pathological tests is emphasized, and they must be performed in the quality control and accurate methods of various laboratory equipment, and maintain a safety laboratory environment, medical waste treatment, quality control of test value, and record keeping. Institutions that train veterinary nurse should focus on nursing and medical assistance and other hospital management tasks such as guardian counseling, management of supplies, drug management, waste management, and various clinical pathological tests to help diagnose, so increase their treatment efficiency of animal hospitals and veterinarians.

본 연구는 점오염원인 하수종말처리장으로부터 배출되는 물의 수질을 분석하고 배출수의 영향을 받는 어류 중 지점들에서 공통적으로 출현하는 어종인 피라미 (Z. platypus) 를 선택하여 조직학적 변화를 참조하천 지점의 수질과 어류 조직을 비교·분석하였다. 2019년 6월 27~28일 하수종 말처리장 4곳 (대전, 전주, 청주, 익산)의 채집 결과, 참조하 천에서 22종 450개체로 가장 많은 종수 및 개체수가 확인 되었다. 지점별로 5개체씩 2~3년생 피라미의 조직표본을 제작하여 아가미와 근육조직 (피부조직)을 관찰한 결과, 참조하천을 제외한 나머지 지점의 조직은 병리적인 양상을 나타내었다. 수질분석 결과, 각 WTP에서는 배출수질 기준을 준수 혹은 더 좋은 수질로 방류하고 있었다. 그러나 하수종말처리수 배출수 및 방류수계 수질에서 오염도지표를 나타내는 항목인 BOD, COD, TP, TN, SS 값이 참조하천에 비해 높은 것으로 나타났다. 빈약한 어류상과 바이오마커로 이용된 종의 조직병리학적 상태는 참조하천에 비해 낮은 수질에서 기인한 것으로 추측되며, 따라서 원인이 되는 하수종말처리장 배출수 수질개선이 이루어져야 할 것으로 사료된다.

본 연구는 파킨슨 질환(Parkinson’s disease) 마우스 모델을 대상으로 지구성 운동과 MitoQ 섭취가 뇌의 흑질의 미토콘드리아 기능에 미치는 영향을 확인하는데 목적이 있다. 파킨슨 질환을 유도하기 위해 C57BL/6 수컷 마우스를 대상으로 복강 내 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP) 25mg/kg과 흡수를 돕기 위한 probenecid 250mg/kg을 이용하여 주 2회 5주간 총 10회 투여하였다. 실험 집단은 생리식염수를 투여하는 집단(Normal Conrol (NC), n=10), MPTP 투여집단(MPTP Control (MC), n=10), MPTP 투여 + MitoQ 투여집단(MPTP + MitoQ (MQ), n=10), MPTP 투여 + 운동집단 (MPTP + Exercise (ME), n=10), MPTP 투여 + MitoQ 투여 + 운동집단(MPTP + MitoQ + Exercise (MQE), n=10) 총 5 집단으로 구성하였으며, 운동집단은 지구성 운동을 실시하였고 MitoQ집단은 점진적으로 250μmol로 늘리면서 5주간 섭취하였다. 연구결과 Rotarod-test에서 MC 집단에 비해 처치 집단은 운동 기능 저하의 개선을 보였다. 또한 MC 집단에 비해 처치 집단은 tyrosine hydroxylase의 수준의 증가와 알파시누클린(α-synuclein) 단백질 축적을 감소시켰다. 그리고 미토콘드리아 생합성에 주요조절 인자인 PGC-1α와 항산화 효소인 Catalase 발현이 MC 집단에 비해 처치 집단에서 증가해 미토콘드리아 기능을 개선했으며, 세포사멸 조절인자인 Bcl-2의 증가와 Bax의 감소를 통해 세포사멸을 완화했다. 따라서 5주 간의 지구성 운동과 MitoQ 섭취는 파킨슨 질환에서 나타나는 병리학적 특징을 완화하고 운동기능을 향상 시키는데 효과적인 것으로 나타났다.

본 연구는 아유르베다와 중국전통의학에서 바라보는 질병에 대한 병리적 이해를 비교하였다. 두 전통의학은 고대로부터 내려온 의학체계로 수많은 유형의 질병을 극복하여 온 역사적 기록들로 이루어져 있다. 아유르베다에서는 질병의 원인으로 심신의 잘못된 사용과 감각기관의 과잉 사용 혹은 부족한 사용과 자연을 거스르는 행동으로 꼽았다. 중국전통의 학에서는 질병의 원인을 외인으로 외부 사기의 침범, 내인으로 칠정의 손상, 불내인으로 외상과 음식 및 과로라고 보았다. 질병의 발현을 보는 관점도 차이가 있다. 아유르베다에서는 도샤의 불균형을 질병 발현의 핵심으로 본다. 반면에 중국전통의학에서는 음양의 평형이 파괴되는 것을 주요인으로 본다. 질병의 발전과 변화단계를 보면, 아유르베다에서는 6단계로 나눈다. 도샤의 불균형, 자극단계, 분산, 재배치, 출현단계이며 마지막으로 분화단계는 합병증이 발생하는 단계이다. 중국전통의학에서 질병의 발전과 변화단계를 살펴보면, 사기와 정기의 변화단계를 거쳐 음양 평형의 파괴 단계, 기혈의 병리 변화단계, 생리 장애단계 이며 마지막으로 장부의 병기 발생단계로 나눈다. 두 전통의학에서는 건강한 삶을 위해서는 질병의 원인이 되는 행동이나 환경으로부터 주의가 필요하며, 질병 발현의 초기 단계에서 불균형을 인식하고 더이상 진행이 되지 못하게 하는 것에 주력해야 함을 강조하고 있다.

췌장낭성종양의 병리진단에서 분자병리 검사의 활용은 통상적인 세포 또는 조직 진단이 어려운 경우 점진적으로 확대될 것으로 예상된다. 세포 또는 낭액에서 검사 결과에 필요한 충분한 디오시리보핵산(DNA)이 확보된다면 특정 유전자 변이를 확인해서 췌장낭성종양의 감별 진단이 가능하며 대표적인 유전자 변이에는 KRAS, GNAS, CTNNB1, VHL 변이 등이 있다. 하지만 분자병리 검사를 활용하는 경우에도 임상-영상의학적 소견을 참고하여 기본적인 병리진단을 한 후에, 이를 뒷받침하는 자료로 활용되는 것이 바람직하다. 차세대염기순서분석 검사는 소량의 세포 또는 조직으로 다수의 유전자 변이를 동시에 확인할 수 있는 장점이 있어 사용되는 범위가 확대될 것으로 기대되지만 적절한 정도 관리를 거치지 않으면 위음성의 결과로 보고될 위험성이 있으며 병리의사의 정도 관리를 거친다고 하더라도 30% 내외의 실패율을 보일 수 있다고 보고되어 있다.

This study includes the clinical features of diabetic patients with fascial space infections of head and neck and those of non-diabetic patients. We retrospectively studied 62 patients who were treated for fascial space infections of the head and neck, and compared the patients’ background, the aetiology of the infection, clinical variables, laboratory values, and treatment process. Statistical analyses of the differences between groups were made with Student's t test, the chi square test, and analysis of variance, as appropriate. Diabetic patients had more spaces involved, had longer hospital stays, and developed more complications. The main microorganism of diabetic group was Klebsiella pneumonia and otherwise, Streptococcus spp. was for non-diabetic group. We conclude that diabetic patients are more likely to develop complications and it is necessary to consider about dominant microorganism when using medication for diabetes patients

Differential diagnosis of the malignant lesion and the benign lesion is critically important for the precise treatment. A clinician should diagnose in a comprehensive manner considering clinical, radiological, and histopathological perspectives. The lesion in the oral cavity in this study was clinically and radiologically malignant. However, the lesion was histopathologically benign. Surgical intervention was not performed except biopsy. The lesion improved after about one month of supportive medication after the biopsy. The importance of decision making process was emphasized in this report.

담낭암의 대표적인 조직형은 담낭 점막의 상피세포에서 기원하는 선암(adenocarcinoma)이며, 형태적 유사성에 따라 담도성(biliary), 장관성(intestinal), 위의 소와세포성(foveolar), 혹은 편평상피성(adenosquamous) 등으로 분류할 수 있다. 선암의 전암성 병변은 3가지가 있으며 1) 선종(adenoma), 2) 담도상피내종양(BilIN), 3) 담낭내 유두상 종양(intracystic papillary neoplasm)으로 구분할 수 있다. 이런 전암성 병변은 공통적으로 세포학적 이형성을 갖는 점막 상피 세포의 증식이라는 특징을 갖고 있으나, 종양 세포가 점막 아래 간질을 침습하지 않은 상태의 병변이다. 내강 내로 돌출된 폴립 모양의 병변이나 점막이 과립상으로 비후된 경우, 선종 혹은 담낭내 유두상 종양의 경우가 많으며, 육안상 확인되지 않으나 현미 경적으로 상피 세포의 이형성이 관찰될 경우 담도상피내종양에 해당한다. 이런 전암성 병변은 이형성의 정도에 따라 저등급(low), 중등급(moderate), 고등급 이형성(high grade dysplasia) 의 3등급으로 평가하고 있으며, 고등급의 경우 상피내 암(carcinoma in situ)과 동일한 병변으로 취급하고 있다. 선종과 담낭내 유두상 종양은 형태학적 특징이 중복되는 부분이 있어, 진단의 재현성을 높이기 위한 형태학적 기준 마련이 필요한 병변이다. 담낭 선암에서 보고된 가장 대표적인 분자 유전학적 변이는 KRAS, TP53과 CDKN2A가 알려져 있고 ERBB2의 증폭도 알려져 있으나, 담도암에 특이적이면서 변이율이 높은 유전자는 많지 않다. 전암성 병변에서 선암으로 이어지는 암발생 과정에서 단계적으로 발견되는 분자유전적 변이 또한 전암성 병변의 종류나 만성 담낭염, 췌담도 기형 등의 위험인자 유무에 따라 보고율이 서로 달라, 한 가지 기전으로 설명하기는 어렵다. 만성 담낭염을 선행인자로 갖는 경우 점막 상피의 증식 혹은 화생의 초기 단계에서 COX-2 과발 현이나 TP53 변이, 마이토콘드리아 DNA 손상이 발생하고, 초기 이형성 단계에서 3p, 8p 염색체의 이형접합성 소실(loss of heterozygosity, LOH) 및 HER2 증폭이 보고되고 있고, 상피내종양에서는 9p, 18q, 22q, 17p 염색체의 LOH 및 CDK2A 변이가 관찰되는 것으로 알려져 있다.

식후 소화불량 및 복통을 주소로 내원한 54세 여자 환자가 영상 검사 및 간조직검사를 통해 절제 불가능한 국소 진행성 간내담관암으로 진단을 받았다. 환자는 진단 이후 총 40주기 의 gemcitabine 및 cisplatin 병합 항암화학요법 이후 수술적 절 제가 가능하다고 판단되어 확대 간우엽절제술 및 간문맥 구역 절제술을 시행 받은 뒤 병리학적 완전 관해로 판정되어 추가적 치료 없이 경과를 관찰하며 6년 이상 장기생존 중이다. 본 증례를 통해 절제가 불가능한 국소 진행성 간내담관암 또한 적극적인 항암화학요법을 통해 병리학적 완전 관해에 이르러 장기생존을 도모할 수 있음을 알게 되었으며, 향후 이와 비슷한 환자의 치료에 있어 최근 연구되고 있는 다양한 방법 들을 이용한 적극적인 치료가 필요하다고 생각된다.

The aim of this study was to present the clinical, radiological, and histopathological findings of 20 new Korean GOC cases with a brief literature review. The mean age of 20 GOC patients was 43.5 years (range, 29-73 years) with a strong predilection for male (male-to-female ratio, 4:1). Nine cases were located in the maxilla and 11 cases in the mandible. Eight cases involved the anterior areas of the jaws and 12 cases were located in the posterior area. Most of the cases (16/20, 80.0%) showed a well-defined unilocular radiolucency and some showed cortical perforation (55.6%) and bony expansion (72.2%) in computed tomography. The most common histopathological feature was eosinophilic cuboidal cells (100%), followed by clear cells (95.0%), mucous cells (85.0%), variations in thickness (85.0%), and intraepithelial microcysts (80.0%). All cases were surgically treated by enucleation and no recurrences were found in routine follow-up.

Osteonecrosis is defined as non-vital bone tissue as a result of abnormal process of osseous healing, and is caused by several reasons such as infection, radiation, and medication. Osteomyelitis, osteoradionecrosis, and medication related osteonecrosis of the jaws (MRONJ) which have necrotic bone in common are confused clinically due to similar symptoms and radiographic findings, and are difficult to diagnose definitively. Because each disease represents a separate clinical progress and requires a different treatment approach, it is very important to distinguish each disease. The aim of this study was to analyze the histopathologic features of osteomyelitis, osteoradionecrosis, MRONJ and to understand their different pathogenesis.

곤충병원성선충은 지상부와 지하부 서식 해충에 모두 병원성을 나타내지만 토 양을 서식처로 하고 있는 천적자원이다. 따라서 곤충병원성선충의 탐색은 주로 토 양시료를 채취하여 미끼곤충을 투입하는 방법을 주로 사용하면 때대로 토양 내에 서 치사 된 감염치사충으로부터 분리하기도 한다. 우리나라에서 곤충병원성선충 자원의 탐색은 1990년대 초에 최초로 이루어져 499개의 토양 시료 중 23개 지역 토 양에서 곤충병원성선충을 분리한 바 있고, 이후 2000년과 2010년대 초반에 전국단 위 조사가 수행되어 세계적으로 2과 76종의 곤충병원성선충들 중 우리나라에서는 2과 6종 30여 계통이 채집되고 있다. 이러한 채집 된 곤충병리자원들은 체계적인 관리가 제한적으로 이루어지고 있다. 따라서 국내 토착 생물자원의 탐색과 유용생 물자원의 확보적인 측면에서 곤충병원성선충을 비롯한 곤충병리 생물자원의 국가 단위의 체계적 발굴과 보존에 대한 협업과 시설 확보가 절실한 실정이다.

Ampulla of Vater (AoV) is a small dilated duct less than 1.5 cm long, formed by the union of pancreatic duct and common bile duct. AoV has also anatomic layer of mucosa, sphincter of Oddi, perisphincteric or duodenal submucosa, and duodenal proper muscle, which corresponds to mucosa, muscularis mucosa, submucosa, and proper muscle layer of other gastrointestinal tract organs, respectively. Because of its small compact size and variation of anatomic structure, it is sometimes difficult to identify layering architecture of AoV. This anatomic difficulty may cause some problem in T classification of ampullary carcinoma (AC). The most confusing point in T classification is the vague definition of T2, “Tumor invades duodenal wall”. It seems that duodenal wall includes duodenal mucosa, submucosa, and proper muscle layer. However there is no precise description or definition about duodenal wall that might lead personal variation in T classification of AC staging. We found that clinical course of AC with perisphincteric and/or duodenal submucosal invasion is more close to AC with T2 than T1. Although it is described as T1b according to T classification scheme of ordinary gastrointestinal tract cancer, we thought AC with T1b may have more high-grade malignant potential than those of other gastrointestinal (GI) tract malignancy. AC showed various clinicopatholgic findings that represent heterogeneous tumor groups within category of AC. Recently site-specific classification of AC was introduced, and it showed relatively well-categorized clinical prognosis. It may be reasonable to understand site-specific tumorigenesis in AC. The standard gross protocol is needed to evaluate pathologic T classification of AC. In conclusion, ampullary neoplasm is composed of various subtypes, which require a separate approach according to anatomic epicenter of ampullary neoplasm. Although submucosal invasion in AC was classified into pT1b, its’ biologic behavior is more close to pT2.

A mucocele is a pseudocyst containing spilt mucin from extravasation of the oral minor salivary gland. For this study, 115 cases of mucoceles diagnosed at the Department of Oral Pathology, Seoul National University Dental Hospital were reviewed with respect to gender, age, lesion’s site, size, color, histopathologic features, and recurrence. There was no significant difference between male and female. Nearly 80% cases occurred in young people under the age of 30 (29.7% in the third decade with the highest prevalence). The lower lip (75.7%) was the most common site, followed by ventral surface of the tongue, mouth floor, and buccal mucosa. The lesions measured from 2 to 20 mm in diameter and appeared in various colors. Histopathologically, mucoceles showed pseudocystic cavities containing mucin surrounded by granulation tissues with foam cells. Among the 115cases, 14 showed recurrence on the adjacent sites. Those cases treated with and without removal of the feeding glands on excision of mucoceles showed recurrence rates of 9.2% and 18.0%, respectively. Based on these results, it is recommended that mucoceles be treated with surgical excision of the feeding salivary glands. There were no clinicopathological results significantly different from the established facts regarding the mucoceles of Korean patients

The purpose of this study was to examine the state of the articles in the Korean Journal of Oral and Maxillofacial Pathology and overall research trends in this field in an effort to grasp the reality of the Journal and suggest some of the right directions for the development of research in this field. 332 articles that were printed in the Korean Journal of Oral and Maxillofacial Pathology over the past decade (2003-2012) were selected for the purpose of analysis. As a result of analysing the 332 articles in 52 issues of the Journal, it's found that a mean of 6.3 articles were contained in each issue. As for the form of article, original articles was more common than case reports, which were respectively used in 275 articles (82.8%) and 57 articles (17.2%). Concerning research methods by year, cell culture was most prevailing (124 articles, 37.3%), followed by clinicopathologic study (68, 20.5%), case report (62, 18.8%), animal experiments (28, 8.4%), clinical trial study (28, 8.4%) and others (22, 6.6%). As to the number of researchers, the majority of the articles were written by two or more researchers. The most common number of researchers was three (66 articles, 19.9%), and the number of the articles written by two (49, 14.8%) was similar to that of the articles written by four (47, 14.2%). 38 articles (11.4%) were written by eight researchers or more. Regarding the language of the articles, Korean was used in 213 articles (64.2%), and English was used in 119 articles (35.8%). As for the number of references, this number ranged from a low of zero(in the articles related to the history of pathology) to a high of 71, and the average number of references was 27.91. In relation to the themes of research, the largest number of the articles (47, 32.6%) dealt with oral squamous cell carcinoma, followed by diseases related to odontogenic carcinoma (21, 14.5%), diseases related to odontogenic cyst (17, 11.7%), salivary gland tumor (seven, 4.8%) and granuloma (five, 3.5%). The efforts by this study to explore the shifts of articles and recent research trends are expected to provide useful information on how to accelerate the identity building of this journal and the development of research in oral and maxillofacial pathology.