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김묘징 ( Myo Jing Kim ),이기열 ( Ki Yeol Lee ),기창석 ( Chang Seok Ki ),송기훈 ( Ki Hoon Song ),김영훈 ( Young Hun Kim ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.2
Incontinentia pigmenti (IP) is a rare X-linked dominant, multisystem genodermatosis that affects ectoderm-derived structures. Its cutaneous manifestations are usually subdivided into the vesicular, verrucous, hyperpigmented, and hypopigmented or atrophic stages. IP can also affect other ectoderm-derived structures, such as, hair, nails, teeth, eyes, and the central nervous and musculoskeletal systems. About 80% of IP patients have genomic deletions of exons 4∼10 of the NEMO (NF-κB-Essential MOdulator) gene, also known as the IKKy (gamma-subunit of the inhibitor κB kinase), which is essential for the activation of the NF-κB pathway. The female infant presented in this case report was born to healthy non-consanguineous parents and showed vesiculopustular eruptions with a NEMO gene rearrangement. No IP case has been previously reported to be related to a NEMO gene mutation in South Korea. In other words, this is the first report to confirm the relation between IP and mutation of the NEMO gene in Koreans. (Korean J Dermatol 2011; 49(2):164∼168)
Intussusception and Jejunal Atresia Caused by an Ectopic Pancreas in a Newborn
Kim, Han-Sol,Lee, Sun-Young,Han, Song-Hee,Nam, So-Hyun,Jo, Chae-Ku,Kim, Myo-Jing The Korean Society of Neonatology 2021 Neonatal medicine Vol.28 No.2
Ectopic pancreas is defined as an abnormally located pancreatic tissue not sufficiently connected with the normal pancreas, which rarely occurs in neonates. To our knowledge, only a few cases of ectopic pancreas have been reported in newborns in South Korea. We report a case of ectopic pancreas as the cause of intussusception and jejunal atresia in a newborn. This clinical association is extremely rare, and this is the first report in South Korea.
ERK Activation by Fucoidan Leads to Inhibition of Melanogenesis in Mel-Ab Cells
Song, Yu Seok,Balcos, Marie Carmel,Yun, Hye-Young,Baek, Kwang Jin,Kwon, Nyoun Soo,Kim, Myo-Kyoung,Kim, Dong-Seok The Korean Society of Pharmacology 2015 The Korean Journal of Physiology & Pharmacology Vol.19 No.1
Fucoidan, a fucose-rich sulfated polysaccharide derived from brown seaweed in the class Phaeophyceae, has been widely studied for its possible health benefits. However, the potential of fucoidan as a possible treatment for hyperpigmentation is not fully understood. This study investigated the effects of fucoidan on melanogenesis and related signaling pathways using Mel-Ab cells. Fucoidan significantly decreased melanin content. While fucoidan treatment decreased tyrosinase activity, it did not do so directly. Western blot analysis indicated that fucoidan downregulated microphthalmia-associated transcription factor and reduced tyrosinase protein expression. Further investigation showed that fucoidan activated the extracellular signal-regulated kinase (ERK) pathway, suggesting a possible mechanism for the inhibition of melanin synthesis. Treatment with PD98059, a specific ERK inhibitor, resulted in the recovery of melanin production. Taken together, these findings suggest that fucoidan inhibits melanogenesis via ERK phosphorylation.
Song, Heesang,Hwang, Hye Jin,Chang, Woochul,Song, Byeong-Wook,Cha, Min-Ji,Kim, Il-Kwon,Lim, Soyeon,Choi, Eun Ju,Ham, Onju,Lee, Chang Youn,Park, Jun-Hee,Lee, Se-Yeon,Choi, Eunmi,Lee, Chungkeun,Lee, Myo National Academy of Sciences 2011 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.108 No.1
<P>Despite the safety and feasibility of mesenchymal stem cell (MSC) therapy, an optimal cell type has not yet emerged in terms of electromechanical integration in infarcted myocardium. We found that poor to moderate survival benefits of MSC-implanted rats were caused by incomplete electromechanical integration induced by tissue heterogeneity between myocytes and engrafted MSCs in the infarcted myocardium. Here, we report the development of cardiogenic cells from rat MSCs activated by phorbol myristate acetate, a PKC activator, that exhibited high expressions of cardiac-specific markers and Ca(2+) homeostasis-related proteins and showed adrenergic receptor signaling by norepinephrine. Histological analysis showed high connexin 43 coupling, few inflammatory cells, and low fibrotic markers in myocardium implanted with these phorbol myristate acetate-activated MSCs. Infarct hearts implanted with these cells exhibited restoration of conduction velocity through decreased tissue heterogeneity and improved myocardial contractility. These findings have major implications for the development of better cell types for electromechanical integration of cell-based treatment for infarcted myocardium.</P>
재활치료환자의 비위관(nasogastric tube)제거에 따른 비디오 투시연하검사(VFSS)의 중요성 평가
정묘영(Myo young Jung),최남길(Nam gil Choi),한재복(Jae bok Han),송종남(Jong nam Song),김원진(Weon jin Kim) 한국방사선학회 2015 한국방사선학회 논문지 Vol.9 No.1
뇌경색, 뇌 신경장애 및 뇌졸중환자 중 급성기 환자는 의식이 없어 연하기능장애로 인한 흡인성 폐렴을 유발하기 때문에 비위관(nasogastric tube)을 삽입하고 영양공급을 한다. 재활훈련 후 회복기에 침상선별검사를 시행하지만 임상적 검사를 통해서는 무증상흡인은 발견할 수 없다. 그래서 연하장애로 비위관을 삽입한 연하재활치료 중인 환자 10명을 대상으로 VFSS를 시행하여 식이재료에 따른 삼킴 정도, 자세에 따른 삼킴을 재활의학과전문의가 평가 후, 흡인이 있거나 삼킴 곤란 등이 있으면 연하재활치료를 시행하여 환자의 상태에 따라 약 30일∼50일후에 재평가를 시행한 후 흡인이 없을 시 비위관을 제거 하였다. 이때 VFSS 영상을 기능적 연하곤란척도를 이용, 분석하여 부여된 점수를 통계 산출 하였는데 비위관 유지군은 49.79±9.431을 보여 흡인의 위험을 나타내며, 비위관 제거군은 11.20±1.932로 흡인의 위험성이 낮아 비위관 제거관련 의미 있게 낮은 점수를 보였다. 두 군의 유의성을 평가하기 위해 Mann-Whitney test를 시행한 결과 𝑝<0.001로 통계적으로 유의하다고 평가하였다. 결론적으로 VFSS는 구강, 인두, 식도의 구조적 이상과 움직임을 가장 효과적으로 평가, 기도흡인여부를 즉시 확인 및 환자에게 적합한 식이나 연하자세를 결정할 수 있어 비위관 제거를 위한 연하평가에 가장 확실한 표준검사로 제안할 수 있다. Acute phase patients who are unconscious and are suffering from cerebral infarction, cranial nerve disorders, or cerebral apoplexy are susceptible to aspiration pneumonia due to dysphagia. In these cases, a nasogastric tube is inserted to supply nutrients. Although bedside screening tests are administered during recovery after rehabilitation, clinical examinations may not be able to ascertain asymptomatic aspiration. Therefore, a video fluoroscopy swallowing study (VFSS) was performed in 10 patients with dysphagia after rehabilitation therapy; these patients had nasogastric tubes inserted, and a rehabilitation specialist assessed the degree of swallowing based on the patients' diet and posture. If aspiration or swallowing difficulties were observed, dysphagia rehabilitation therapy was administered. The patients were reassessed approximately 30 50 days after administration of therapy, based on the patients' condition. If aspiration is not observed, the nasogastric tube was removed. A functional dysphagia scale was used to analyze the VFSS images, and the scores were statistically calculated. The mean score of patients with nasogastric tubes was 49.79 ± 9.431, thereby indicating aspiration risk, whereas the group without nasogastric tubes showed a mean score of 11.20 ± 1.932, which indicated low risk of aspiration. These results demonstrated that a significantly low score was associated with nasogastric tube removal. Mann-Whitney's test was performed to assess the significance of both the groups, and the results were statistically significant with a P value <0.001. In conclusion, VFSS can effectively assess the movements and structural abnormalities in the oral cavity, pharynx, and esophagus. It can also be used to determine the aspiration status and ascertain the appropriate diet or swallowing posture for the patient. Therefore, VFSS can potentially be used as a reliable standard test to assess swallowing in order to determine nasogastric tube removal.
LC : Spontaneous Ruptured Umbilical Hernia in a Patient with Alcoholic Cirrhosis
( Byung Su Kim ),( Ki You Myo ),( Jun Hwa Song ),( Yong Kook Lee ),( Jeong Bae Park ),( Jeong Ill Suh ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background: In patient with ascites due to alcoholic cirrhosis, spontaneous perforation of an umbilical hernia is unusual but potentially life-threatening event. We present a case of a cirrhotic patient with long standing tense ascites and an umbilical hernia who experienced evisceration of a section of the small intestine through the hernia. Case: A 55-year-old man was visited to an OPD due to sudden onset of central abdominal discomfort. The patient had a history alcoholic cirrhosis, with gradual development of tense ascites over the past years. He had inflammation of hernia area and oozing before 1 week. Initial vital sign were: blood pressure 120/80 mmHg, heart rate of 95 beats/min, respiratory rate of 20 breaths/min, oxygen saturation of 97%, and temperature of 36.5μL. The patient was alert and fully oriented. Laboratory studies revealed a white blood cell count 8,400/μL, hematocrit of 27%, platelets of 215,000, sodium of 124 mmol/L, potassium of 4.8 mmol/L, chloride of 93 mmol/L, BUN of 21mg/dL, creatinine of 1.2 mg/dL, AST of 26 IU/L, ALT of 4 U/L, serum albumin of 2.0 g/dL, and internal normalized ration of 1.84. The patient was taken directly to the operating room. The hernia sac and ulcerated umbilical skin were excised and the incision closed primarily. After surgery he was haven ventilation care due to dyspnea and fever. The patient had sepsis during ventilator care, we used teicoplanin to cover Methicillin-Resistant Staphylococcus aureus. Despite treatment, septic condition aggravated and developed to ARDS. He died after 2 weeks. Conclusions: In patient with cirrhosis and tense ascites, umbilical hernia can break down completely, with expulsion of intraabdominal contents. It is rare but life threatening. Potential complications are incarceration or strangulation of bowel, and the development of peritonitis, and sepsis. Herniorrhapy is simple procedure, but in liver cirrhosis patient, surgical repair itself incurs great risk who as a rule already have decompensated liver disease. The physician must think of choice medical treatment or surgery.