쌍생아에서 발생한 Intestinal Neuronal Dysplasia

임인숙,정주영,최명재,김상우,김홍주,김정연,Lim, In-Suk,Chung, Ju-Young,Choi, Myung-Jai,Kim, Sang-Woo,Kim, Hong-Ju,Kim, Jeong-Yeon 대한소아소화기영양학회 2003 Pediatric gastroenterology, hepatology & nutrition Vol.6 No.2

장신경 이형성증은 만성 가성 폐색 증후군의 드문 원인질환으로 임상 증상이 선천성 거대결장증과 유사하여 진단이 늦어지는 경우가 많기 때문에 임상적인 의심이 필요하다. 저자들은 쌍생아에서 신생아기에 태변이 배출되지 않고 복부 팽만을 보여 선천성 거대결장증이 의심되었으나 임상경과와 조직검사로 진단된 장신경 이형성증을 보고하는 바이다. Intestinal neuronal dysplasia (IND) is a disorder of abnormal intestinal innervation resulting in dysfunctional colonic motility. IND shares clinical features with Hirschsprung's disease but differentiated by histological findings such as hyperplasia of submucosal and myenteric plexuses, giant ganglia, ectopic ganglion cell and increased acetylcholinesterase activity in lamina propria. Although IND may exist as an isolated condition, more commonly, it occurs in association with Hirschsprung's disease. We report a case of twins affected with IND. Both children manifested with delayed passage of meconium and severe abdominal distention after birth. Barium enema in both patients showed microcolon. They underwent emergency ileostomy under the impression of total aganglionosis. But surgical biopsy specimens showed hyperganglionosis in submucosa with formation of giant ganglia. Both neonates suffers from several episodes of peudo-obstruction after the repair operation of colostomy.

Ureaplasma urealyticum의 집락에 따른 신생아의 임상 양상

임인숙 ( In Suk Lim ),최창원 ( Chang Won Choi ),김병일 ( Byeong Il Kim ),김상덕 ( Sang-duk Kim ),이진아 ( Jin A Lee ),김이경 ( Eu Kyung Kim ),김한석 ( Han Suk Kim ),최중환 ( Jung Hwan Choi ) 대한주산의학회 2007 Perinatology Vol.18 No.1

목적: Ureaplasma urealyticum (U. urealyticum)은 태아와 신생아 폐렴의 중요한 원인으로 밝혀져 있으며 미숙아에서 기관지폐 이형성증의 발생과 관련이 있다고 보고되어졌다. 저자들은 U.urealyticum의 집락 여부에 따른 신생아들의 임상양상을 비교 분석하고자 하였다. 방법: 2003년 6월부터 2006년 7월까지 분당 서울대학교병원 신생아 중환자실에 입원한 환아 중 출생 첫날 U. urealyticum에 대한 검사를 시행한 476명을 대상으로 하였다. 소변 또는 기관지 폐포 흡인액중에서 PCR 또는 배양검사를 시행하여 U. urealyticum 양성군과 음성군간의 신생아 호흡 곤란증후군 및 기관지폐 이형성증의 빈도를 비교하였다. 결과: 출생 첫날 U. urealyticum에 대한 검사를 시행한476명 중 재태 연령 32주 미만은 136명이었고 재태 연령 32주 이상은 340명이었다. 재태 연령 32주 미만의 환아에서는 18명(13%)이 U.urealyticum 양성이었고 이들에서 기관지폐 이형성증의 발생빈도는 U. urealyticum 음성군에 비해 유의하게 높았고(p=0.058), 신생아 호흡 곤란 증후군의 발생빈도는 적었다(p=0.043). 생후 3일의 말초 혈액에서 총백혈구수는 U. urealyticum 양성군에서 유의하게 증가되어 있었으며(p=0.003), 이차이는 중성구에서 더 뚜렷하였다(p=0.001). 총 IgM과 CRP는 U. urealyticum 집락과 유의한 관계가 없었으며 산모 양수에서 U. urealyticum의 집락여부와 환아의 U. urealyticum의 집락여부도 유의한 관계가 없었다. 재태 연령 32주 이상의 환아에서는 23명(7%)이 U. urealyticum 양성이었고 이들에서 기관지폐 이형성증의 발생은 없었으며 신생아 호흡 곤란 증후군의 발생빈도는 감소하지 않았다 (p=0.605). 환아의 총 IgM은 U. urealyticum 양성군에서 증가하였으나(p<0.006) 환아의 총백혈구와 CRP는 유의한 증가를 보이지 않았다. 산모의 U. urealyticum 집락여부와 환아의 U. urealyticum의 집락여부도 유의한 상관관계가 없었다(p=0.21). 결론: U. urealyticum의 집락은 재태 연령 32주 미만의 미숙아에서 기관지폐 이형성증의 발생빈도를 증가시켰고 신생아 호흡 곤란 증후군의 발생빈도는 감소시켰다. Objective: Ureaplasma urealyticum colonization is a significant cause of fetal and neonatal pneumonia and is associated with the prevalence of bronchopulmonary dysplasia (BPD) in preterm infants. This study was aimed to evaluate the relationship between U. urealyticum colonization and neonatal morbidity Methods: We tested 476 infants for U. urealyticum on the first day of life among infants admitted to the neonatal intensive care unit of Bun-dang Seoul National University Hospital from June 2003 to July 2006. Urine and endotracheal aspirates were processed by PCR (polymerase chain reaction) or culture for U. urealyticum colonization. We compared the morbidity in the colonized group with the non-colonized group. Results: The study group consisted ot 136 infants less than 32 weeks of gestational age and 340 infants more than 32 weeks of gestational age. In infants less than 32 weeks of gestational age, 18 (13%) of 136 infants had 1 or more positive specimens by culture or PCR. BPD occurred more in the colonized group than in the non-colonized group (p=0.058) and respiratory distress syndrome (RDS) occurred significantly less in the colonized group (p=0.043). Total WBC counts on the third day of life was significantly increased in the colonized group (p=0.003) and this significance was prominent in the neutrophil fraction (p=0.001). There was no significant relation between U. urealyticum colonization and IgM levels nor C-reactive protein (CRP) level nor U. urealyticum colonization of the mother. Twenty-three(7%) of 340 infants more than 32 weeks of gestational age had 1 or more positive specimens by culture or PCR. BPD didn`t occur and RDS didn`t decrease significantly in the colonized group (p=0.605). Total IgM levels didn`t increase significantly in the colonized group (p<0.006) but total WBC counts and CRP levels didn`t increase significantly in the colonized group. There was no significant relation between U. urealyticum colonization and U. urealyticum colonization of the mother (p=0.21). Conclusion: U. urealyticum colonization in infants less than 32 weeks of gestational age was associated with an increased prevalence of BPD and a decreased prevalence of RDS.

뇌량의 부분 발육부전을 동반한 4q Deletion 1례

강미나,임인숙,김병의,최명재,김상우,Kang, Mi Na,Lim, In Suk,Kim, Byeong Eui,Chey, Myoung Jae,Kim, Sang Woo 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.2

저자들은 짧은 사지를 가지고 태어난 생후 2일된 여자 신생아에서 뇌량의 부분 발육부전과 특징적인 임상소견을 보이면서 염색체 검사상 4번 염색체 장완 간질부결손으로 확진된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Syndrome of 4q deletion is characterized by an abnormal shape of the skull, craniofacial dysmorphism, cardiovascular malformations, genitourinary defects, limb and digital anomalies, and developmental delay. We experienced a case of 4q interstitial deletion in a 2 day-old female neonate who showed short extremities, partial agenesis of corpus callosum and congenital heart defects. We report the case with a brief review of the literature.

Landau-Kleffner 증후군의 임상적 고찰

강훈철 (Hoon Chul Kang),임인숙(In Suk Lim),황용순(Yong Soon Hwang),박상근(Sang Keun Park),김흥동(Heung Dong Kim) 대한소아신경학회 2003 대한소아신경학회지 Vol.11 No.2

목 적 : LK 증후군의 특징적인 발병 원인, 임상경과와 더불어 다양한 치료 방법에 따른 성적을 분석하여, 향후 LK 증후군의 치료 및 관리에 저자들의 경험이 도움이 되고자 한다. 방 법 : 1996년부터 최근까지 2년 이상 추적 관찰이 가능했던 LK 증후군 환아 5명을 대상으로 의무 기록을 분석하였다. 관련된 원인 질환들을 찾고, 치료에 도움을 얻고자 뇌MRI, SPECT, FDGPET을 필요에 따라 시행하였으며, 일부 환아에서 대사 이상 질환에 대한 평가도 병행하였다. 항경련제를 비롯한 스테로이드 호르몬 치료, 정맥용 면역 글로불린, 케톤생성식이요법, 다발성 연막하 절개술의 치료 성적을 비교 분석하였다. 결 과 : 다섯명의 대상 환아 중 남자 환아 2명, 여자 환아 3명으로, 간질 발작과 실조증 발생 나이는 1년 10개월에서 8년 6개월로 다양하였다. 1명 환아에서 발병 원인으로 추정되는 사립체 전자 전달체 이상이 발견되었다. 스테로이드 호르몬 치료제 실조증 증상의 호전을 보였던 환아가 2명이었으며, 이 중 1명은 호르몬 치료 종료와 함께 실조증이 다시 악화되는 소견을 보였다. 케톤생성식이요법을 시행했던 3명의 환아 중 사립체 전자 전달체 이상을 보였던 1명에서 사립체 질환에 대한 보조 약물 투여와 함께 획기적인 임상적 호전을 보였다. 나머지 두명에서는 다발성 연막하 절개술을 시행했으나, 1명에서만 부족하나마 호전된 임상 경과를 볼 수 있었다. 결 론 : LK 증후군은 다양한 임상 경과와 관련된 원인 질환을 보일 수 있다. 더불어 치료에 있어 실조증을 포함한 인지 행동 장애의 호전이 무엇보다 중요하다고 할 수 있으며, 이를 위해 스테로이드 호르몬, 케톤생성식이요법이 적용될 수 있고, 다발성 연막하 절개술은 내과적인 치료가 실패했을 때 고려해 볼 수 있다 하겠다. Purpose : We intended to describe the clinical features including characteristic etiologies, therapeutic approaches and outcomes for Landau-Kleffner syndrome(LKS). Methods : A retrospective chart reviews were done to reveal the clinical and electrophysiological features in 5 patients who were diagnosed as LKS and undergone extensive diagnostic work-up and various therapeutic interventions. Results : Among five LKS patients, 2 patients were males and 3 were females. All patients showed well controlled seizure outcomes but cognitive function including auditory and/or expressive aphasia were not improved in spite of using various anticonvulsants. Only two patients responded to steroid therapy but one patient showed repeated deterioration after discontinuation of the durg. Among 3 patients who were on ketogenic diet(KD), one patient showed a dramatic improvement in liguistic and cognitive functions in spite of underlying mitochondrial complex I deficiency. Multiple subpial transections (MST) were done in the other two patients because of incomplete recovery from ketogenic diet, and only one patient showed fairly successful improvement. Conclusion : Cognitive regression induced by LKS could be successfully improved by various therapeutic modalities including steroid, KD and palliative MST in most patients.

위암의 (胃癌) 통계학적 관찰과 병리조직학적 (病理組織學的) 분류의 문제점에 대하여

홍숙희(Sook Hee Hong),석동수(Dong soo Suk),주종은(Jong Eun Joo),임인숙(In Sook Lim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A Total 211 lesions of stomach cancer were collected from the pathology department of the Pusan Paik Hospital during 1979 and 1985. Statistical analysis was carried out showing the following findings; 1) Among the total 211 cancers, male 139 and female 72. The male-female ratio is 2:1. 2) Average age is 52 years, male 54.7 and female 47.5 years old. These figures are 7 years lower than Japanese, and 4 years lower than Americans, clearly suggesting higher carcinogenic agents present in the Korean environment (food). 3) The size of the gastric cancer is 2-5 cm in diameter in the majority of the cases. Those of female are 0.6 cm larger in the average diameter than those of male. 4) The site of the cancer is antrum in half of all cases, the next is body and pylorus. 5) Depth of cancer invasion into the gastric wall shows the serosa the most frequent, 37.4%, the next is subserosa, 28.4%. There was the Early Gastric Cancer in 11% among all cancers of the stomach. 6) Metastasis of the regional lymph nodes was found in 66.8%. The frequency of the metastasis is increasing proportionally with the size of the cancer and the depth of the cancer invasion in the gastric wall. 7) Histopathology of the stomach cancer shows in the following order; poorly differentiated(38.4 %), moderately differentiated(22.7%) and well differentiated(18.5%). Together of these three types consist of 80% of total lesions. There is a distinct difference between male and female on the histological types, for there are 52% in undifferentiated and 48% in differentiated types among male while 72% and 28% among female groups. In average, they are 60% and 40%, respectively. 8) Prominent infiltration of lymphocytes in the stroma is found 2-5% of the cancers. Promenent proliferation of fibrous connective tissue of the stroma is found in 3-9% of the cancers. 9) The distinct difference in female group such as lower age group and more frequent association with undifferentiated form, will be elucidated by genetic disposition, and should be tested by tissue typing. 10) The histopathological classification should be as those of the traditional detailed description of the histopathological types. It will be much benefitcial having a standard classicfication adopted by all institutes of Korea such as the currently adopted method of japanese institutes

조직구 괴사성 림프절염 : A Clinicopathologic Study of 20 Cases

임인숙,석동수 인제대학교 1988 仁濟醫學 Vol.9 No.2

1979년 6월부터 1987년 12월까지 만 8년 7개월 동안 경험한 조직구 괴사성 림프절염 20예에 대한 임상 및 병리조직 표본을 검사하여 문헌 고찰과 함께 보고하는 바이다. The clinicopathological features of histiocytic necrotizing lymphadenitis in 20 patients are described. This disease occurs predominantly in third decade of life with a mean of 27 years, and is predominantly more common in female (F : M = 5.7 : 1). The most common symptom is multiple cervical lymphadenopathy in 18 of 20 patients(90%) and occasionally pain (35%) and fever (15%) are accompanied. Duration of cervical lymphadenopathy is 4 to 90 days with a mean of 27.4 days. Laboratory findings including viral and bacterial study are non-contributory except for leukopenia and raised erythrocyte sedimentation rate (ESR) in 52.9% and 87.5% in patients, respectively. Characteristic histological feature is multifocal, well-circumscribed, paracortical necrotizing lesions, and abundant karyorrhectic debris, a mixture of lymphocytes and histiocytes or macrophages with active phagocytosis of karyorrhectic nuclear debris and degenerating cells. Granulocyte and plasma cell infiltation is absent. The etiology of histiocytic necrotizing lymphadenitis is unknown. Histiocytic necrotizing lymphadenitis would be induced by the abnormal T cell-histiocyte response against some causative agents which induce a similar reaction of delayed hypersensitivity.

헤어 장식을 위한 조형성에 관한 연구

임인숙,류지원 한국미용학회 2000 한국미용학회지 Vol.6 No.1

According to this, the beauty of decorative hair was classified with the theory of designing and meaning of decoration by using an example, up style tied hair entirely that is wanted plenty of idea of designing. This was in the meaning to not only the simple standard to judge the style as a good thing or bad but also the rational standard to find out the hairstyle how good or bad. And the creative expression way like plait, weave was presented and a concept of hair texture was recognized with the hair only. Conclusion would be followed First, the beauty of decorative hair always is with a concept of technology, art and design. Second, the expression way of hair could be represented by various and creative training. Third, it was needed to be responsible as a hair designer and hair artist through the system-atical education and the appropriate attitude. I hope this to be helpful in understanding a concept of the beauty of decorative hair.

유방의 평 활근육종 -1예 보고-

임인숙,석동수 대한병리학회 1987 Journal of Pathology and Translational Medicine Vol.21 No.1

Kleinefelter 증후군 1예

林慶浩,崔秀全,朴聖信,林仁淑,崔熙奭 인제대학교 1983 仁濟醫學 Vol.4 No.4

We reported a case of Kleinefelter's Syndrome with typical features, which was consisted of increased gonadotropins, gynecomastia, eunuchoidism, and small atrophic testis.

미용실무전개를 위한 형태학적 접근에 관한 연구 : 헤어디자인을 중심으로

곽형심,임인숙 한국미용학회 1999 한국미용학회지 Vol.5 No.1

In the morden society meeting higer customer's demand improved social status for hair designers, hair design has been adapting a new design concept into its works based on artistic notion its typical technique oriented old customs. From the hair designer point of view, the most important thing is how to find customer's needs exactly, and then how to create the very perfect hair style that the custom wants to have. The solution may be gained throughout a successfrl combination of eath factor hair design consists of. Througout an analysis of a morphological notion in hair design by factorial approach, I would like to propose methological instance, and I could have following conclusions. firstly, hair design can be interpreted differently by a new approach with modeling concept applied to basic techniques. Secondly, hair designer needs to have his of her pride in that he or she contribute people to improve their mental satisfaction which is closly related to human basic instinct for having happiness, beauty and good appearance. Finally the description of the work process, from initial observation when it happens in the phrase of hair design planning how to apply basic geograhical concept like triangele, retanglar and circel to detailed observation in the phrase of its implementation how to apply more complicated concept like oval, curve round shape, proposed diversfed visual approaches. Also, it includes an analysis of hair line, line flow on changed hair style, the effect of dimension by light, angle concpt of hair dimensional space. Finally, the study approached a morphological concept from the art & design point based on texture observation for image analysis. I except that this sudy will be supporting to the improvement of new hair design approaches based on a combination of technical and artistic as well as good theorical background.