Clinical implications of DMSA Scan in Childhood Acute Pyelonephritis

허선미,박보경,강현미,임정우,서진순,이경일 대한소아신장학회 2017 Childhood kidney diseases Vol.21 No.2

Purpose: This study aimed to evaluate the relationships between 99mTecniciumdimercaptosuccinic acid (DMSA) scan findings and clinical parameters including age and fever duration. Methods: The positive rates for abnormal DMSA scans were analyzed according to the age of patients, fever duration prior to admission, and total fever duration. DMSA scan findings were divided into 3 categories: single defect, multifocal defects, and discrepant defects. We evaluated the detection rates of vesicoureteral reflux according to DMSA scan lesions. Results: Among a total 320 cases, 141 (44.1%) had abnormal DMSA scans. The infant group (0-1 year of age) had a shorter total fever duration, and a lower Creactive protein (CRP) value and DMSA positive rate (39.8% vs. 60.6%, P =0.002) compared to children group (2-15 years of age). Patients with abnormal scans had a longer total fever duration and higher CRP compared to those with normal scans. The positivity rate of abnormal scans did not differ between the patients with a short fever duration prior to admission of ≤2 days and those with longer fever duration of ≥3 days. However, patients with longer total fever duration had a higher rate of abnormal DMSA scans (P =0.02). Among cases with a single defect, multifocal defects, and discrepant defects, vesicoureteral reflux was observed in 22.4%, 60% and 70.6% of cases, respectively (P =0.004). Conclusion: Although DMSA scan has limitations in early diagnosis, DMSA scan findings may aid in the prediction of the severity of systemic inflammation and detection of vesicoureteral reflux.

말하지 않는 우정

허선미 샘터사 2004 월간 샘터 Vol.408 No.-

Therapeutic Plasma Exchange in Pediatric Kidney Disease: 23-year Experience at the Severance Children’s Hospital in Korea

허선미,이금화,김지홍,이재승,김평길,신재일 대한소아신장학회 2017 Childhood kidney diseases Vol.21 No.2

Purpose: The American Society for Apheresis provides clinical guidelines for therapeutic apheresis in adults, but there are no guidelines for children. This study aimed to analyze the effect of therapeutic plasma exchange (TPE) in pediatric patients with various kidney diseases in Korea. Methods: We retrospectively reviewed the data of 16 children (up to 18 years of age) who were admitted to Severance Children’s Hospital with refractory kidney disease. All patients received TPE between 1994 and 2016. Clinical and laboratory characteristics such as age, weight, sex, change in blood urea nitrogen (BUN), and creatinine level before and after TPE, and complications after TPE were analyzed. Results: The mean age and weight of the 16 patients at the time of TPE was 11.3± 4.0 years and 34.6±17.5 kg, respectively. The BUN level was 35.4 mg/dL before TPE and significantly decreased to 21.5 mg/dL (P =0.025) at 1 week and 20.5 mg/dL (P = 0.01) at 1 month after TPE. The creatinine level significantly decreased from 1.20 mg/dL before TPE to 0.90 mg/dL (P=0.02) at 1 week after TPE. Four complications (hypovolemia, anemia, hypocalcemia, and thrombocytopenia) were reported, but were not fatal. Conclusion: Our findings suggest that TPE is an effective therapeutic modality in children with refractory kidney disease and can be indicated for the treatment of various kidney diseases.

벼 종자에서 액포막 aquaporin (tonoplast intrinsic protein) 유전자의 발현과 기능

허선미,윤인선,이인숙,김범기,신영섭,이강섭,김둘이,변명옥,김동헌 한국식물생명공학회 2010 식물생명공학회지 Vol.37 No.4

Rice seed maturation and germination involve drastic changes in water and nutrient transport, in which tonoplast aquaporins may play an important role. In the present study, gene expression profiles of 10 tonoplast intrinsic proteins (TIP) from rice were investigated by RT-PCR during seed development and germination. OsTIP3;1 and OsTIP3;2 were specifically expressed in mature seeds. Their transcript level rapidly decreased after onset of seed germination and gene expression was induced by ABA treatment. In contrast, expression of OsTIP2;1 and OsTIP4;3 was not seed specific as transcripts were found in vegetative tissues as well. Their respective transcript levels decreased at an early stage of seed development, whereas they increased at a later stage of seed germination and elongation of embryonic roots and shoots. When seed germination was inhibited by various stress conditions and ABA, expression of OsTIP2;1 and OsTIP4;3 was completely suppressed. In contrast, the expression level of OsTIP2;2 rapidly increased after seed imbibition and the transcript level was maintained under conditions inhibiting seed germination. These results implicate that tissue specific and developmental transcriptional regulation of OsTIPs in rice seeds depends on their specific function. In addition, OsTIPs can be discriminated by different potential phosphorylation and methylation sites in their protein structures. OsTIP3;1 and OsTIP3;2 possess unique phosphorylation signatures at their N-terminal domain, loop B and loop E, respectively. OsTIP2;1 and OsTIP4;3 have a potential methylation site at their Nterminal domain. This suggests that activity of specific tonoplast aquaporins may be regulated by post-translational modification as well as by transcriptional control. 종자 발달과 발아는 수분과 양분 함량의 급격한 변화를수반하는 복합적인 과정이다. 본 연구에서는 유전자 발현과 단백질 구조 비교 분석을 통해 벼 종자의 발아와 발달과정에 관여하는 액포막 aquaporin (tonoplast intrinsic protein)을 규명하였다. OsTIP3;1, OsTIP3;2는 종자 특이적인 TIP로 종자가 성숙되는 시기에 발현되었다가, 종자가발아하면서 전사체가 사라지는 양상을 보였으며, ABA 처리에 의해 발현이 유도되었다. 단백질 구조 예측 결과로부터 OsTIP3;1, OsTIP3;2가 단백질의 N-말단, B와 E loop에 다른 TIP와 뚜렷이 구분되는 인산화 잔기 특징을 확인하였다. OsTIP2;1과 OsTIP4;3은 종자가 발달하는 과정에서 유전자 발현이 감소하였다가, 종자 발아 후기에 뿌리와 배축의 신장이 활발한 시기에 발현이 급증하였다. 특히 OsTIP2;1은 뿌리에서 강한 발현을 보였으므로, 뿌리생장에 필요한 팽압 공급에 중요한 기능을 할 것으로 제안된다. OsTIP2;1과 OsTIP4;3 단백질의 N-말단에는 특징적으로 메틸화 (methylation) 가능성이 높은 아미노산 잔기가 예측되었다. OsTIP2;2는 OsTIP2;1과는 달리 종자 침윤 후 7시간 이내에 발현이 빠르게 유도되며, 발아가 억제되는 조건에서도 유전자 발현이 유지되는 것으로 보아종자의 초기 수화 과정에 관여할 것으로 추측된다. OsTIP2;2단백질의 N-말단에는 OsTIP2;1에 존재하는 인산화 Ser 잔기와 메틸화 잔기가 결실된 특징을 보였다. 이런 결과들은 벼 종자의 발달과 발아 과정에서 나타나는 액포의 종류와 기능에 따라 서로 다른 TIP가 선택적으로 유전자발현수준에서 조절되며, 인산화, 메틸화 등 단백질 수식에 의한 활성조절 기작 역시 매우 다르다는 것을 시사한다.

A Successfully Treated Case of Recurrent Focal Segmental Glomerulosclerosis (FSGS) with Plasmapheresis and High dose Methylprednisolone Pulse Therapy

허선미,이금화,신재일 대한소아신장학회 2017 Childhood kidney diseases Vol.21 No.2

Focal segmental glomerulosclerosis (FSGS) in children, which is a kind of nephrotic syndrome showing steroid resistance, usually progresses to a substantial number of end stage renal disease (ESRD). Although the pathogenesis of primary FSGS is unclear, several recent studies have reported that FSGS is associated with circulating immune factors such as soluble urokinase-type plasminogen activator receptor (suPAR) or anti-CD40 autoantibody. We report a successfully treated case of a 19-year-old female patient who experienced a recurrence of primary FSGS. After the diagnosis of FSGS, the patient progressed to ESRD and received a kidney transplantation (KT). Three days later, recurrence was suspected through proteinuria and hypoalbuminemia. She has been performed plasmapheresis and high dose methylprednisolone pulse therapy and shown remission status without increasing proteinuria for four years after KT. In conclusion, strong immunosuppressive therapy may be helpful for a good prognosis of recurrent FSGS, suppressing several immunologic circulating factors related disease pathogenesis.

장애아 전문 어린이집 유아특수교사의 직업 정체성 인식

허선미(Heo, Sun-Mi),황순영(Hwang, Soon-Young) 부산대학교 교육발전연구소 2021 교육혁신연구 Vol.31 No.2

연구목적: 본 연구의 목적은 장애아 전문 어린이집에서 근무하는 유아특수교사의 경험을 바탕으로 직업정체성을 어떻게 인식하는지 알아보는 것에 있다. 연구방법: 5개의 시도 장애아 전문 어린이집에서 3년 이상 근무한 유아특수교사 8명을 대상으로 반구조화된 질문지를 이용하여 페이스톡과 전화통화를 통한 심층면접을 실시하였다. 연구결과: 장애아 전문 어린이집에 근무하는 유아특수교사는 열악한 근무환경과 교사처우를 당연히 받아들이며 그저 힘들게 봉사만 해야하는 봉사자로 인식하고 있었다. 둘째, 장애유아의 장애정도가 심하여 주로 보육시간이 길다보니 보육 위주의 시스템으로 운영됨에 따라 자신이 유아특수교사인지 보육교사인지 직업 정체성의 혼란을 느끼고 있었다. 반면, 장애아 전문 어린이집을 교육·보육기관의 개념이 아닌 만족스러운 보수와 근무환경을 제공하는 직업으로 여기는 유아특수교사도 있었다. 셋째, 어린이집에서 본인이 유일한 특수교육 전문가로 인식하며 사명감을 가지고 장애영유아의 보육 및 교육에 최선을 다하고 있었다. 논의 및 결론: 장애아 전문 어린이집에 근무하는 유아특수교사의 직업 정체성은 고정된 것이 아니라 다양한 환경과의 상호작용에 의해 변화되고 있으며, 발전적인 방향으로 정체성이 형성될 수 있는 방안을 제언하였다. Purpose: The purpose of this study is to find out how early childhood special education teachers perceive their job identity based on their job experience as a special teacher working at a daycare center specializing in infants with disabilities. Method: To this, 8 early childhood special education teachers who have worked at daycare centers specializing in infants with disabilities in five cities and provinces for more than three years conducted in-depth interviews through face talk and phone calls using semi-structured questionnaires. Results: the results showed that special education teachers working at daycare centers specializing in infants with disabilities took the poor working conditions and treatment of teachers and recognized them as volunteers who had to work hard. Second, since the degree of disability of infants with disabilities is severe and the daycare time is long, they were feeling confused about their professional identity whether they were special education teachers or nursery teachers. On the other hand, there were special education teachers who recognized daycare centers for infants with disabilities as a job that provides satisfactory remuneration and working environment rather than concepts of educational and childcare institutions. Third, the daycare center recognized him/her as the only special education expert, so he/she was doing his/her best in education and daycare for infants with disabilities with a sense of duty. Conclusion: Based on these results, we can see that the job identity of a special education teachers working at a daycare center specializing in infants with disabilities is not fixed, but changed by interactions with various environments, and suggested ways to form an identity in a developmental direction.

고학력 결혼이주여성의 탈구위치와 인정투쟁

허선미(Sunmee Huh),최인이(Inyi Choi) 충남대학교 사회과학연구소 2016 사회과학연구 Vol.27 No.4

종자 휴면과 수발아성에 대한 양적형질 (QTL) 유전자 연구 동향

허선미(Sun Mi Huh),한혜주(Hay Ju Han),김범기(Beom-Gi Kim),권택윤(Taek Yun Kwon),이강섭(Gang Sub Lee),윤인선(In Sun Yoon) 한국육종학회 2016 한국육종학회지 Vol.48 No.1

Seed dormancy is an important adaptive mechanism to protect seeds under the unfavorable environments. Unlike to wild type species, the seed dormancy trait of cultivated crops has been weakened by breeding programs during the domestication period. Weak seed dormancy often causes preharvest sprouting (PHS) problem in many cereal crops that result in significant economic loss. The seed dormancy is a quantitative trait loci (QTL) controlled by multiple genetic and environmental factors. So far, many QTLs for seed dormancy have been identified from rice and wheat as well as in the model plant Arabidopsis. Unveiling of QTL genes and complex mechanisms underlying seed dormancy is accelerated by the rapid progress of crop genomics. In the present study, we reviewed current status of research progress on the seed dormancy QTLs and correlated genes in Arabidopsis and cereal crops.

한국산 겨우살이 Lectin B-chain의 면역증강 효과

김종배,허선미,안효선,김규대,김인보,윤택준,김영훈 한국생약학회 2011 생약학회지 Vol.42 No.3

Korean mistletoe Lectin (KML-C) is composed of A and B sub-chain. B chain binds to carbohydrates on cell surface and A chain hinders translation and induces an apoptosis as a RIP (ribosome inactivating protein). KML-C has very strong biological activities, it has seriously limits to use as a cancer therapy or adjuvant because of its toxicity to normal cells. This study is therefore conducted to see if B chain of KML-C might have immunological activity, especially adjuvant activities with less toxicity. We isolated B chain from KML-C using the lactose affinity chromatography, and examined their immunoadjuvant activity. The isolated B-chain did not show any cytotoxicity against tumor cell, RAW264.7, and P388D1 while KML-C had a very strong toxicity. This non-toxic effect was observed also by in-vivo study. Both humoral and cellular immunities were observed ; the antibody titer was increased when the mice were immunized with B-chain used as adjuvant like Freund’s adjuvant,indicating that B chain of mistletoe lectin alone might be used for adjuvant; it also increased DTH in cellular immunity. These results suggest that B-chain of KML-C might be used for adjuvant used for the production of antibody or vaccine with less toxicity.

Leigh Syndrome: Subgroup Aanalysis according to Mitochondrial DNA Mutation

지나리(Na Lee Jee),허선미(Sun Mi Her),김세훈(Se Hoon Kim),이민정(Min Jung Lee),이철호(Chul Ho Lee),이영목(Young Mock Lee) 대한소아신경학회 2018 대한소아신경학회지 Vol.26 No.1

목적: Leigh 증후군은 진행하는 드문 신경퇴행성 질환으로 중추신경계의 이상을 특징으로 한다. Leigh 증후군 환자들은 다양한 임상증상 및 유전적 이상을 나타내기 때문에 예후를 예측하기 어렵다. 따라서, 본 연구에서는 Leigh 증후군 환자들에서의 미토콘드리아 DNA 돌연변이와 환자들의 임상 양상과의 연관성에 대해 분석하였다. 방법: Leigh 증후군으로 진단받은 환자 중에서 미토콘드리아 DNA유전자 돌연변이 검사를 시행한 85명의 환자들의 자료를 후향적으로 분석하였다. 미토콘드리아 DNA 돌연변이 결과에 따라 환자군을 나누고, 집단 간의 임상 양상 차이를 통계 분석을 시행하였다. 결과: 연구에 참여한 85 명의 환자 중 18 명이 미토콘드리아 DNA 돌연변이를 가지고 있었다. 대부분의 환자는 젖산수치 및 젖산/피루베이트 비율이 20 이상이었으며 이는 호흡 연쇄 반응의 이상에 부합하는 결과였다. 미토콘드리아 DNA 돌연변이가 있는 환자군은 미토콘드리아 DNA 돌연변이가 없는 환자군과 비교하여, 여성 비율, 알라닌 수치, 안구 침범, 자기 공명 영상(MRI)상 중뇌 및 숨뇌 이상이 통계학적으로 유의하게 높았다. 결론: 임상적으로 Leigh 증후군이 의심될 때, 여성환자, 안구침범을 보이는 환자, 높은 알라닌 수치를 보이는 환자, MRI상 중뇌나 숨뇌에 이상소견이 보이는 환자에서는 미토콘드리아 DNA 돌연변이 검사를 우선적으로 고려할 수 있다. Purpose: Leigh syndrome (LS) is a rare, progressive neurodegenerative disorder with characteristic abnormalities in the central nervous system. Such patients present with heterogeneous clinical symptoms and genetic abnormalities; thus, prognosis is difficult to anticipate. The present study investigates whether distinct patient characteristics are associated with mitochondrial DNA (mtDNA) mutation in LS patients. Methods: : We retrospectively analyzed data from patients diagnosed with LS at our hospital who were assessed using genomic sequencing of mtDNA. A subgroup analysis was performed to divide patients according to the mtDNA sequencing results. Results: Among the 85 patients enrolled, 18 had mtDNA mutations. Most patients had lactic acidosis and a lactate/pyruvate ratio above 20, indicating respiratory chain abnormalities. In the subgroup analysis, the mutation group had a significantly higher female-to-male ratio, alanine level, ocular involvement, and midbrain and medulla abnormalities on magnetic resonance imaging (MRI). Conclusion: The subgroup analysis indicates that mtDNA sequencing is recommended for female patients, or those who exhibit ocular involvement, high alanine levels, or MRI findings with lesions in the midbrain and medulla.