The Division of Gastrointestinal/Liver Pathology was one of the first and is perhaps the longest standing Gastrointestinal/Liver Pathology Division in the country. The Division has an extraordinarily rich history of creative research, diagnostic excellence, and quality fellow, resident and medical student education. In many ways, the Division is a microcosm of the breadth and depth of excellence in the broader Department.

The history of the Division encompasses the long careers of Drs. Yardley and Boitnott at Johns Hopkins. Dr. Yardley ’s GI interests began with collaborative studies on inflammatory bowel disease with Drs. Tom Hendrix and Ted Bayless and ultimately grew into a formal fellowship training program, which has trained 22 fellows since 1963. Dr. Boitnott’s interest in liver began during his housestaff training with a summer spent with Dr. Jerry Klatskin at Yale, followed by collaborations at Hopkins with Drs. Frank Iber, Willis Maddrey and Frank Herlong.

Currently, there are eleven faculty members with a primary appointment in the Division and three additional faculty members with secondary appointments. The Division is headed by Dr. Ralph Hruban, who is also one of the Vice-Chairs of the Department. Other members of the Division include Drs. John Yardley, John Boitnott, Belur Bhagavan, James Eshleman, Elizabeth Montgomery, Tsung - Teh Wu, Susan Abraham, Michael Goggins, Gloria Su, and our newest faculty member, Robb Wilentz. Faculty with a secondary appointment in the Division include Drs. Bert Vogelstein, Scott Kern, and Elizabeth Jaffee.

The research interests of the Division are broad, however, they primarily focus on gastrointestinal malignancies. The research laboratories of Drs. Hruban, Goggins, Su, Kern, and Jaffee are focused on the pathobiology of pancreatic cancer. Dr. Hruban studies familial pancreatic cancer (he founded the National Familial Pancreas Tumor Registry) and the precursors to invasive pancreatic cancer. Dr. Hruban will be awarded the Young Investigator Award at the March meeting of the United States and Canadian Academy of Pathology for this work. Dr. Goggins is a gastroenterologist by training. His efforts are directed toward developing an early detection test for pancreatic cancer. Dr. Su is developing new animal models of pancreatic cancer. Using "conditional knock-out" technology, she will recreate the molecular genetic alterations identified in human cancers in a mouse model. These laboratories are generously supported by the family and friends of Michael Rolfe. All three investigators collaborate extensively with Drs. Scott Kern, Elizabeth Jaffee, and Johan Offerhaus. Scott has made most of the fundamental genetic discov-eries in the field of pancreatic cancer, including the discovery of the DPC4 gene and and Liz has developed a novel vaccine to treat pancreatic cancer. Johan has been a long-term participant in the Bowel Tumor Working Group at Johns Hopkins and he has organized numerous scientific collaborations and fellow exchanges between the group at Hopkins and the GI pathology group in Amsterdam.

Drs. Eshleman and Montgomery study colorectal neoplasia. Dr. Eshleman’s laboratory is investigating the role of defects in DNA repair in colon carcinogenesis. He is also involved in translational research in the molecular diagnostics laboratory and is an active member of the Bowel Tumor Working Group. Dr. Montgomery collaborates extensively with Dr. Bert Vogelstein providing much needed collaborative expertise in the pathology of the tumors studied in the Vogelstein laboratory. Our colorectal neoplasia group will be expanded in July with the addition of Dr. Robb Wilentz. Robb was an extraordinarily productive resident in our program. He will join the faculty in July and study the molecular genetic basis of dysplasia in patients with inflammatory bowel disease.

Drs. Susan Abraham and Tsung-Teh Wu form an active collaboration studying the genetic alterations in gastric and esophageal neoplasms, including fundic gland polyps of the stomach and adenocarcinomas arising in the setting of Barrett's esophagus. In addition, Dr. Abraham is currently collaborating with Dr. Scott Kern on his studies of the molecular genetics of pancreatic neoplasia.

The Division's three senior members participate in a variety of clinical pathologic correlation research projects. Dr. John Yardley is revising a popular teaching series with Dr. Hendrix for the American Gastrointestinal Association. Dr. John Boitnott, as always, provides a breadth and depth of expertise in liver pathology as well as avuncular wisdom and advice, and Dr. Belur Bhagavan has a broad range of interests, but focuses his efforts on pediatric GI pathology.

Under the leadership of Dr. Montgomery, the diagnostic service continues to grow. Last year, members of the Division examined biopsies from over 7,500 patients. Difficult cases are reviewed at a weekly diagnostic GI pathology conference and interesting cases are often presented on the Web through the Surgical Pathology Web site (http://pathology2.jhu.edu/sp).

Teaching has always been the cornerstone of Divisional activities. Numerous research fellowships are offered, as well as a two-year combined clinical-research fellowship. The latter fellowship provides a unique opportunity for fellows to become world-class diagnosticians and researchers. This fellowship program was formally started in 1983 with crucial support from the Meyerhoff Fund (Harvey & Lyn Myerhoff) and the Clayton Fund (Ben & Julia Clayton Baker). The quality of this program can be seen in our current applicant pool (we typically have between 10-20 applicants for each fellowship position) and by the numerous awards the fellows have received from the Gastrointestinal Pathology Society and at the Department's Annual Young Investigator Day. The long-term vitality of this combined fellowship is now assured with the creation of the John Yardley Fellowship in Gastrointestinal Pathology. We thank all of you who have honored the contributions of Dr. Yardley by supporting the creation of this fellowship.

Divisional teaching activities extend beyond the fellowship programs and recently have included a number of Web-based initiatives. The Division hosts a number of disease-specific Web pages including popular pages on:

• Barrett's esophagus http://pathology.jhu.edu/beweb,
• Gallbladder and Bile Duct tumors http://pathology.jhu.edu/gbbd
• Colorectal Malignancies http://pathology.jhu.edu/colon
• Pancreatic Cancer http://pathology.jhu.edu/pancreas

The Division also participates in national CME activities, including hosting the Annual Lustgarten Meeting for pancreatic cancer research (to be held June 13 & 14, 2001) and, beginning in Fall, the Division will be offering a diagnostic gastrointestinal pathology course.

The Division also participates in medical student education. The Gastrointestinal/Liver section of the Second Year Pathology Course lasts approximately two weeks and it has proven popular with the students. In the last 5 years, members of the GI/Liver Division have received four teaching awards from the Medical School including the Professor's Award, the W. Barry Wood Award, and the Excellence in Teaching Award (twice).

There is much more going on in the Division, but we hope we have given you a sense of the breadth and depth of the research, patient care and educational activities in the Division.