PIONEERS of PATHOLOGY
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1 조남훈
2 PIONEERS of PATHOLOGY Rudolf Virchow: Father of Pathology Virchow s triad G. Nikolas Pappanicaulau PAP test James Ewing tumor metastasis theory Arias-Stella- AS reaction Azzopardi JG- One sees and recognizes only those features which have already been described. Arthur Purdy Stout- Atlas of Tumor Pathology Stanley L Robbins textbook 1 st ed. Lesions do not arise in cadevars. But the study of morphology is only one facet of pathology. Pathology contributes much to clinical medicine. The pat hologist is interested not only in the recognition of structural alterations, but also in their significance, ie, the effects of these changes on cellular and tissue function and ultimately the effect of these changes on the patient. It is not a discipline isolated from the living patient, but rather a basic approach to a better understanding of disease and therefore a foundation of sound clinical medicine.
3 Pioneers in Korean Pathologists 윤일선교수 ( ): 한국최초의 ( 일본연수 ) 병리학자 세브란스의전교수 - 초대주임교수 최동교수 : 한국최초의 ( 순수국내 ) 연세의대병리학및법의학교수 - 한국최초의종양등록문헌발표 서재필 : 1929 병리학전문의취득하여한국최초의병리전문의 백순명 : 연세의대졸업 - 미국피츠버그대 - 유방암조직은행 - 현삼성병원암연구소소장
4 Alois Alzheimer Von Reklinghausen 인간은생을살려고태어난것이지생을준비하려고태어난것은아니다 하얀거탑
5 Pathologists So far~ Licence doctor- 908명 (2012년) Tissue 검사 : 3,150,000건 / 연간 Cytology 검사 : 4,120,000건 / 연간 160여병원 ( 준종합병원이상 1,200 병원중 15%) 40 대학병원 120 종합병원 37 수탁전문기관 연세대서울대아산삼성가톨릭 조직검사건수 ( 연간 ) 67,000 65, ,000 85,000 58,000 병리학교수 연구교수 전공의 전공의모교출신비율 (%) ~15 >80 ~30 ( 서울대 ) ~30 ( 서울대 ) ~70
6 Pathology (Studying Disease: 病理 ] Understanding of disease mechanism- Why? pathogenesis, etiology What? Morphology How? Pathophysiology, molecular/cellular biology, immunology Embarking on a path of discovery Goal To integrate into pathologic process and disorder- morphology and molecules To organize significant lesions, process and disorder- clinics and biology To clarify the most appropriate language To cover life-long long terms of medicine Nothing worthwhile ever comes easily.
7 The Passion Το Παθοs (To Pathos) passion flower Passiflora coerulea
8 IQ intelligence quotient DQ Digital quotient EQ Emotional intelligence quotient GQ Global quotient MQ Morality quotient NQ Network quotient, Nexus quotient PQ Passion quotient, personality quotient SIQ Social intelligence quotient SQ Spirit quotient IIQ Integration intelligence quotient
9 HeLa cell from Ms. Henrietta Lacks
10 E. inoculation K. 눈 E. eye L. oculus G. Θηλη (the:le:) L. epithelium, -i, m. 상피층 L. endothelium L. mesothelium L. urothelium
11 E. graft G. γραφιο ν (graphion)
12 Demilune ( 반달 )
13 goblet Signet ring
14 Intranuclear Inclusion & longitudinal groove in Thyroid papillary ca Anni s orphan eyes
15 Mitochondria rer
16 Coffee bean Granulosa cell tumor Call-Exner body
17 Cribriform carcinoma Cribriform plate Cribriform bucket Cauliflower Palisading fence Palisading necrosis Palisading nuclei
18 Pathology in post-traineetrainee Basic science in medical institute (Life scientist) Pathogenesis, pathophysiology, molecular and cellular biology, clinical translational biology, validated biology to human samples Practice in hospital with certification (High and secure salary) Final diagnosis-biopsy and resected tissues- stage set-up TNM/ FIGO/ AJCC. Non-invasive diagnosis- cytology Ancillary technique; Immunopathology-IHC, IHC, IF Molecular diagnosis- lymphoma, sarcoma, microbes Pharmacopathololgy- screening for targeted therapy efficacy Prognostication (fortune-telling) telling)- genomics/transcriptomics/proteomics Forensic pathology- autopsy- congenital anomaly, legal Gene bank & tissue bank Digital pathology- telepathology, meta-analysis analysis
19 What contents in the general pathology? Chapter 1: Cell injury- most fundamental process in disease causation Chapter 2-3: Inflammation- repair/stem cell biology-regenerative medicine Chapter 4: Fluid dynamics-circulation circulation injury Chapter 6: Immune disorder Chapter 7: Neoplasia- cancer biology Chapter 8: Infection-microbes 2013; 1 학년 4qt- 2 학년 1qt로이동
20 Systemic pathology-block lecture Circulation- blood vs/heart/lymph node. ( 양우익 ) Aerosystem- Lung ( 심효섭 ) Digestive system- Gastrointestinal ( 김호근, 김현기 ), hepatobiliary ( 박영년 ), pancreas ( 김호근 ) Genitourinary system- Kidney( 정현주, 임범진 ), lower urinary tract, male genital system, female genital system ( 조남훈 ), breast ( 정우희, 구자승 ) Endocrine system ( 홍순원 ) Musculoskeletal system ( 양우익 ) Nervous system ( 김세훈 ) 2-3 학년통합과정에포함됨.
21 From Phenotype-dependent classification to Genotype-dependent revised classification Ex) Cervix intraepithelial neoplasia (CIN) Replicative HPV- low grade squamous intraepithelial lesion (CIN I) Proliferative phase high grade squamous intraepithelial lesion (CIN 2-3) Ovary epithelial-derived ca Serous/mucinous/endometrioid/clear cell Type I (low grade serous/endometrioid, mucinous, clear cell) Type II (high grade serous/endometroid/mmmt) Renal cell ca clear cell/ granular cell/ sarcomatoid Clear (3p loss) Papillary (trisomy) Chromophobe (no genetic change)
22 Gene rearrangement in soft tissue sarcoma
23
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