간내 담도가 확장된 담관낭의 수술 후 간내 담도의 변화

정수민,김혜은,이철구,서정민,이석구,Jung, Soo-Min,Kim, Hea-Eun,Lee, Cheol-Koo,Seo, Jeong-Meen,Lee, Suk-Koo 대한소아외과학회 2009 소아외과 Vol.15 No.1

Choledochal cyst is a congenital dilatation of the bile duct. Intrahepatic bile duct dilatation of type IVa by Todani's classification at the time of diagnosis resolved spontaneously after cyst excision and hepaticojejunostomy in many cases. It should be distinguished from the true cystic dilatation of the intrahepatic ducts, which tends to persist, albeit after some regression. We therefore studied postoperative intrahepatic duct dilatation changes in choledochal cyst. A total of seventy-six choledochal cysts were managed at the Division of Pediatric Surgery, Department of Surgery, Samsung Medical Center from May 1995 to December 2005. The ratio of males to females was 1:2.8. Preoperative radiologic diagnosis by Todani's classification was Type I (n=52, 68.4 %), II (n=1, 1.3 %), IVa (n=23, 30.3 %). Among fifty-five patients with intrahepatic bile duct dilatation we were able to follow up forty-eight by ultrasonography. Twenty-two patients were type IVa, and twenty-six patients were type I and showed intrahepatic duct dilatation. Mean follow-up duration was 35.3 months (9~105 months). Complete regression of dilated intrahepatic duct was observed in fifteen patients of type IVa and twenty-four patients of type I. Incomplete regression of dilated intrahepatic duct was observed in six patients in type IVa and two patients in type I. Only one patient in type IVa showed no change in ductal dilatation during a follow-up period of 15 months. We conclude that true type IVa is much less frequent than what was diagnosed preoperatively by imaging study. Therefore in type IVa patients who are diagnosed preoperatively the decision to perform liver resection should be carefully considered. Postoperative long term follow up of choledochal cyst with intrahepatic bile duct dilation is needed.

초등학교 전이프로그램을 통한 특수아동의 학교 생활 적응과 부모 및 교사의 인식에 대한 사례 연구

정수민 ( Soo Min Jung ),유은정 ( Eun Jung Yoo ) 한국특수아동학회 2009 특수아동교육연구 Vol.11 No.4

소아 환자에서 복강경 복막 투석관 삽입술과 개복 삽입술의 비교

김현수,정수민,이석구,서정민,Kim, Hyun-Soo,Jung, Soo-Min,Lee, Suk-Koo,Seo, Jeong-Meen 대한소아외과학회 2011 소아외과 Vol.17 No.2

The aim of this study was to compare peritoneal dialysis catheter insertion by the open method to the laparoscopic method. Twenty four laparoscopic and 10 open peritoneal dialysis catheter placements were performed in children between 2001 and 2008. Patient characteristics, operation related data, procedural complications and clinical outcome were compared. Although there were no cases of catheter obstruction, exit site infection or bleeding in the laparoscopic group, compared to the open method, there was no statistically significant difference between the two groups. Catheter removal rate due to complication was high in the open group and catheter survival rate was high in the laparoscopic group. We concluded that laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups with at least equivalent functional results compared to the open method. An advantage of laparoscopic catheter insertion is removal of the great omentum and easy fixation of the catheter to the abdominal wall.

소아 환자의 위 주름술에 있어서 복강경과 개복술의 비교

곽홍기,정수민,이석구,서정민,Gwak, Hong-Ki,Jung, Soo-Min,Lee, Suk-Koo,Seo, Jeong-Meen 대한소아외과학회 2012 소아외과 Vol.18 No.2

Fundoplication is a common surgical procedure for gastroesophageal reflux Disease (GERD). Recently the procedure has been performed with increased frequency laparoscopically. The aim of this study is to compare laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF) for GERD in children. We studied retrospectively the 88 pediatric patients who underwent the Nissen fundoplication for GERD as primary antireflux surgery from 1994 and 2009. ONF was performed in 34 cases and LNF was in 54 cases. 58 patients have neurologic impairment. Time to initial food intake after the surgery were reduced in the LNF group (p= 0.032). Recurrent GERD symptom occurred in one patient in LNF group and four patients in ONF group within 1 year after the surgery (p= 0.012). There were no statistically significant differences in post operative morbidity and mortality between both groups. In conclusion, our practice of Nissen fundoplication indicates that LNF takes priority in most pediatric patients.

비후성 유문협착증에 대한 유문근 절개술에서 개복 술식과 복강경 술식의 비교

김수미,정수민,서정민,이석구,Kim, Su-Mi,Jung, Soo-Min,Seo, Jeong-Meen,Lee, Suk-Koo 대한소아외과학회 2011 소아외과 Vol.17 No.2

Hypertrophic pyloric stenosis (HPS) is the most common infantile surgical condition and the standard treatment is open pyloromyotomy. Recently, laparoscopic techniques have rapidly advanced, and the laparoscopic approach has become widely adopted by pediatric surgeons. The aim of this study was to compare the clinical outcomes between open and laparoscopic pyloromyotomy. We retrospectively evaluated outcomes of pyloromyotomy for HPS by the open (OP) and the laparoscopic (LP) method. The procedures were performed at the Samsung Medical Center between September 2001 and March 2009. We analyzed patient age, sex, birth weight, length of hospital stay, postoperative length of stay (LOS), operating time, time to feeding commencement, postoperative vomiting frequency, the time to full feeding without vomiting, and surgical complications. A total of 54 patients were included in the study. There were 26 OP and 28 LP patients. There was no statistically significant difference in age, sex, birth weight, operating time, postoperative emesis. In contrast, postoperative LOS in the LP group was statistically significantly shorter than that in the OP group (2.0 vs. 3.3 days, p=0.0003) and time to full feeding was significantly shorter following LP. (p=0.018) There were no wound complications. Laparoscopic pyloromyotomy significantly reduced postoperative LOS and time to full feeding compared to open pyloromyotomy.

신생아기에 비특이적 증상으로 발현된 선천성 횡격막 탈장 2례

이정민 ( Jeong Min Lee ),서보선 ( Bo Seon Seo ),조희승 ( Heui Seung Jo ),정수민 ( Soo Min Jung ),조기현 ( Kee Hyun Cho ),이규형 ( Kyu Hyung Lee ) 대한주산의학회 2015 Perinatology Vol.26 No.3

Most of the congenital diaphragmatic hernia (CDH) cases are diagnosed at prenatal period or immediately after birth with severe respiratory symptom. The classic triad, which is respiratory distress, apparent dextrocardia and a scaphoid abdomen, is usually seen in this period. Several case reports have described older infants and children with a wide spectrum of symptoms of CDH, whereas extremely few cases were reported in neonatal period except classic triad such as straungulation of the bowel. These atypical manifestations can lead physician to delayed diagnosis. We report two cases of CDH newborns. First case was diagnosed with pneumoperitoneum following tension pneumothorax, transient diaphragm eventration on 5 days after birth. The other case was diagnosed with failure to thrive and mediastinal mass on 30 days after birth. These cases suggest physicians to consider CDH in late newborn period with pneumoperitoneum following tension pneumothorax, transient diaphragm eventration, failure to thrive, and mediastinal mass.

3T3-L1 지방전구세포에서 Quercetin이 Matrix Metalloproteinases 억제에 의한 지방세포 분화에 미치는 영향

송승민(Seung Min Song),정수민(Soo Min Jung),최수진(Su Jin Choi),김우경(Woo Kyoung Kim) 한국식품영양과학회 2022 한국식품영양과학회지 Vol.51 No.4

본 연구는 3T3-L1 지방전구세포에서 quercetin이 MMPs를 억제하여 지방세포의 분화와 지방축적, 신혈관생성을 억제한다는 기전을 규명하는 것을 목적으로 수행되었다. 3T3-L1 지방전구세포에 PMA를 처리하면 MMP-2와 MMP-9의 mRNA 발현과 활성이 유의적으로 증가하였으며, PMA와 함께 quercetin을 처리하면 quercetin의 처리농도가 증가함에 따라 MMP-2와 MMP-9의 mRNA 발현과 활성이 유의적으로 감소하였다. 그리고 PMA를 처리하면 3T3-L1 세포에서 세포 내 지방축적과 GPDH 활성, 지방세포분화와 관련된 전사인자인 C/EBPβ, C/EBPα, PPARγ 및 FABP4의 mRNA 발현이 유의적으로 증가하였으며, PMA와 quercetin을 함께 처리하면 세포 내 지방축적과 GPDH 활성, 지방세포분화와 관련된 전사인자들의 mRNA 발현이 quercetin의 처리농도가 증가함에 따라 유의적으로 감소하였다. 또한 3T3-L1 지방전구세포에 PMA를 처리하면 혈관내피세포 성장인자인 VEGF-A와 그 수용체인 VEGFR-2의 mRNA 발현이 유의적으로 증가하였으며, PMA와 함께 quercetin을 처리하면 quercetin의 처리농도가 증가함에 따라 VEGF-A와 그 수용체인 VEGFR-2의 mRNA 발현이 감소하였다. 그러므로 본 실험 조건에서 quercetin은 MMPs를 억제해 지방세포의 분화와 지방축적, 신혈관생성을 저해한다는 작용기전을 확인하였다. The purpose of this study was to investigate the inhibitory effects of quercetin on differentiation and angiogenesis via matrix metalloproteinases (MMPs) in 3T3-L1 preadipocytes. The adipocytes were treated with quercetin (0, 5, 10, and 20 μM) for 24 h and the activation of the MMPs was induced by phorbol 12-myristate 13-acetate (PMA) (100 ng/mL) (PMA+) for 2 h. The mRNA expression and activity of MMP-2 and MMP-9 were measured using a real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay kit, respectively. Oil-Red-O (ORO) staining and glycerol-3-phosphate dehydrogenase (GPDH) activity were measured. Also, the mRNA expressions of CCAAT/enhancer-binding protein (C/EBP) β, C/EBPα, peroxisome proliferator-activated receptor (PPAR) γ, fatty acid-binding protein (FABP) 4, vascular endothelial growth factor (VEGF)-A, and vascular endothelial growth factor receptor (VEGFR)-2 were measured using a real-time PCR. The mRNA expression and activity of MMP-2 and MMP-9 were significantly increased in the quercetin 0 μM (PMA+) group compared to the quercetin 0 μM (PMA−) group, and they were significantly decreased by quercetin treatment (P<0.05). ORO staining and GPDH activity were significantly increased in the quercetin 0 μM (PMA+) group compared to the quercetin 0 μM (PMA−) group, and they were significantly decreased by quercetin treatment (P<0.05). The mRNA expressions of C/EBPβ, C/EBPα, PPARγ, FABP4, VEGF-A, and VEGFR-2 were significantly increased in the quercetin 0 μM (PMA+) group compared to the quercetin 0 μM (PMA−) group, and they were significantly decreased by the quercetin treatment (P<0.05). In conclusion, quercetin can inhibit differentiation and angiogenesis in 3T3-L1 preadipocytes through the suppression of MMPs.

1세 전후로 진단된 장 회전이상증의 임상적 특징

허정민,문석배,정수민,신현백,서정민,이석구,Huh, Jeung-Min,Moon, Suk-Bae,Jung, Soo-Min,Shin, Hyun-Baik,Seo, Jeong-Meen,Lee, Suk-Ku 대한소아외과학회 2010 소아외과 Vol.16 No.2

Malrotation is a congenital anomaly that becomes symptomatic more frequently during infancy. The indication for surgical treatment at that age is straightforward. In older children, the diagnosis may be more difficult because of chronic and vague complaint. The aim of this study is to compare the symptoms, rate of volvulus and surgical findings in children younger and older than one year. A retrospective study of 40 patients in a a single medical center diagnosed with malrotation from April 1996 to May 2010 was performed. There were 20 (50 %) boys and 20 (50 %) girls. At the time of operation, 27 (67.5 %) patients were younger and 13 (32.5 %) were older than 1 year. Vomiting was seen in 20 cases (74.1 %) of the younger group compared to 2 cases (15.4 %) of the older group. Abdominal sonography and upper gastrointestinal series showed a sensitivity of 100%. Operative findings: 12 (44.4 %) of the younger group presented with volvulus compared to none of the older group. The Ladd's procedure was routinely performed with appendectomy in all cases and bowel resection was requires when volvulus included bowel necrosis or other anomalies were found. After definite procedures, surgical correction for adhesive obstruction was necessary in 5 menbers (18.5 %) of the younger group and 1 patient (7.7 %) in the older group. There was 1 death due to respiratory failure and pneumonia. Abdominal pain was more frequent symptom and bilious vomiting was less frequent. Volvulus did not occur in the older group. Malrotation should be diagnosed promptly in children over 1 year of age by upper gastrointestinal series and abdominal ultrasonography even though symptoms are not as clear cut as in infants.