Treatment and classification of nevus of ota: a seven- year review of a single institution’s experience

( Han Saem Kim ),( Jae Yun Lim ),( Ju Yeon Choi ),( Jung In Kim ),( Jung Min ),( Hyun Min Seo ),( Sang Hyeon Hwang ),( Young Jun Choi ),( Ho Joo Jung ),( Jae Hui Nam ),( Ga Young Lee ),( Won Serk Kim 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

Background: Nevus of Ota is a common dermal melanocytic disease in Asian, and appears as mottled brown or blue-gray pigmented macules on the face. Various laser treatment including ruby, alexandrite or Nd:YAG has been widely used. Objectives: The purpose of the study was to inspect the clinical outcomes of laser treatment and to review the clinical type of nevus of Ota. Methods: Sixty-seven patients treated with laser for nevus of Ota between 2009 and 2015 were included. Data were obtained with retrospective chart review and two dermatologists evaluated clinical improvement on photographs taken at each visit. Results: Mean age of the patients was 12.7【13.4 years, and male-to-female ratio was 1:1.23. Clinically, severe, moderate and mild grade of nevus of Ota were 9, 30, and 28 of patients, respectively. By Tanino’s classification, type IA and type II were equal (28%) and 24 of patients (36%) were unspecified. 45 (67%) involved eyelids. 27 (40%) of patients showed excellent outcomes and 20 of 67 (30%) achieved good outcomes. Mean frequency of treatment was 13.30【7.65. Treatment sessions (16.9【7.1) in the excellent outcome group were significant (P < .05) compared to that in the unattained group (9.3【3.9). Conclusion: Laser is an effective and safe modality for the treatment of nevus of Ota. Tanino’s classification seems to be not satisfactory for classification of nevus of Ota. A new clinical classification would be necessary.

The impact of a quality improvement effort in reducing admission hypothermia in preterm infants following delivery

Choi, Han Saem,Lee, Soon Min,Eun, Hoseon,Park, Minsoo,Park, Kook-In,Namgung, Ran The Korean Pediatric Society 2018 Clinical and Experimental Pediatrics (CEP) Vol.61 No.8

Purpose: Hypothermia at admission is associated with increased mortality and morbidity in preterm infants. We performed a quality improvement (QI) effort to determine the impact of a decrease in admission hypothermia in preterm infants. Methods: The study enrolled very low birth weight (VLBW) infants born at Gangnam Severance Hospital between January 2013 and December 2016. This multidisciplinary QI effort included the use of occlusive wraps, warm blankets, and caps; the delivery room temperature was maintained above $23.0^{\circ}C$, and a check-list was used for feedback. Results: Among 259 preterm infants, the incidence of hypothermia (defined as body temperature <$36.0^{\circ}C$) decreased significantly from 68% to 41%, and the mean body temperature on neonatal intensive care unit admission increased significantly from $35.5^{\circ}C$ to $36.0^{\circ}C$. In subgroup analysis of VLBW infants, admission hypothermia and neonatal outcomes were compared between the pre-QI (n=55) and post-QI groups (n=75). Body temperature on admission increased significantly from $35.4^{\circ}C$ to $35.9^{\circ}C$ and the number of infants with hypothermia decreased significantly from 71% to 45%. There were no cases of neonatal hyperthermia. The incidence of pulmonary hemorrhage was significantly decreased (P=0.017). Interaction analysis showed that birth weight and gestational age were not correlated with hypothermia following implementation of the protocol. Conclusion: Our study demonstrated a significant reduction in admission hypothermia following the introduction of a standardized protocol in our QI effort. This resulted in an effective reduction in the incidence of massive pulmonary hemorrhage.

Ca<SUP>2⁢</SUP>-activated K<SUP>⁢</SUP> Currents of Pancreatic Duct Cells in Guinea-pig

Han-Wook Lee,Jingchao Li,Na-Youn Koo,Zheng Gen Piao,Sung Min Hwang,Jae-Woong Han,Han-Saem Choi,Jong-Heun Lee,Joong Soo Kim,Kyungpyo Park 대한생리학회-대한약리학회 2004 The Korean Journal of Physiology & Pharmacology Vol.8 No.6

There are numerous studies on transepithelial transports in duct cells including Cl<SUP>⁣</SUP> and/or HCO<SUB>3</SUB><SUP>⁣</SUP>. However, studies on transepithelial K<SUP>⁢</SUP> transport of normal duct cells in exocrine glands are scarce. In the present study, we examined the characteristics of K<SUP>⁢</SUP> currents in single duct cells isolated from guinea pig pancreas, using a whole-cell patch clamp technique. Both Cl<SUP>⁣</SUP> and K<SUP>⁢</SUP> conductance were found with KCl rich pipette solutions. When the bath solution was changed to low Cl<SUP>⁣</SUP>, reversal potentials shifted to the negative side, ⁣75⁑4 mV, suggesting that this current is dominantly selective to K<SUP>⁢</SUP>. We then characterized this outward rectifying K<SUP>⁢</SUP> current and examined its Ca<SUP>2⁢</SUP> dependency. The K<SUP>⁢</SUP> currents were activated by intracellular Ca<SUP>2⁢</SUP>. 100 nM or 500 nM Ca<SUP>2⁢</SUP> in pipette significantly (P<0.05) increased outward currents (currents were normalized, 76.8⁑7.9 pA, n=4 or 107.9⁑35.5 pA, n=6) at ⁢100 mV membrane potential, compared to those with 0 nM Ca<SUP>2⁢</SUP> in pipette (27.8⁑3.7 pA, n=6). We next examined whether this K<SUP>⁢</SUP> current, recorded with 100 nM Ca<SUP>2⁢</SUP> in pipette, was inhibited by various inhibitors, including Ba<SUP>2⁢</SUP>, TEA and iberiotoxin. The currents were inhibited by 40.4⁑% (n=3), 87.0⁑% (n=5) and 82.5⁑% (n=9) by 1 mM Ba<SUP>2⁢</SUP>, 5 mM TEA and 100 nM iberiotoxin, respectively. Particularly, an almost complete inhibition of the current by 100 nM iberiotoxin further confirmed that this current was activated by intracellular Ca<SUP>2⁢</SUP>. The K<SUP>⁢</SUP> current may play a role in secretory process, since recycling of K<SUP>⁢</SUP> is critical for the initiation and sustaining of Cl<SUP>⁣</SUP> or HCO<SUB>3</SUB><SUP>⁣</SUP> secretion in these cells.

Beneficial effect of low fluence 1,064nm Q-switched neodymium:yttrium-aluminum-garnet laser in the treatment of senile lentigo

( Han Saem Kim ),( Jae Yun Lim ),( Ju Yeon Choi ),( Jung In Kim ),( Jung Min ),( Hyun Min Seo ),( Sang Hyeon Hwang ),( Young Jun Choi ),( Ho Joo Jung ),( Jae Hui Nam ),( Ga Young Lee ),( Won Serk Kim 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

Background: Low fluence 1,064nm Q-switched Neodymium: Yttrium-Aluminum-Garnet (Nd:YAG) laser has been widely used for pigmentary disorders. Up to now, there has been no reliable study to evaluate an effect of 1,064nm Q-switched Nd:YAG laser for senile lentigo. Objectives: This study was performed to investigate the beneficial effect of low fluence 1,064nm Q-Switched Nd:YAG laser in treatment for senile lentigo on the face. Methods: A retrospective review was conducted on patients treated with fluence 1,064nm Q-switched Nd:YAG laser for the purpose of skin brightening. Only 14 patients with multiple senile lentigos were included in this study. All side effects were recorded to assess the safety of the modality. Results: Mean age of patients was 56.7【10.7 years old and male-to-female ratio was 1:6. Mean treatment fluence was 1.57【0.26J/cm2, and mean total treatment sessionwas 9.5【2.1. Mean interval period between each session was 25.7【11.7 days, and mean treatment session to reach marked improvement was 8.7【2.3. At final visit, 9 of 14 (64.3%) reached near total and marked improvement, and 4 of 14 (28.6%) reached moderate improvement. 2 of 14 (14.3%) experienced transient pigmentary changes. Conclusion: Low fluence 1,064nm Q-Switched Nd:YAG laser may be considered as an effective and safe optional modality for the treatment of senile lentigo.

A case of penicillamine-induced dermopathy in Wilson`s disease

( Han Saem Kim ),( Jung Yup Kim ),( Sun Min Lim ),( Jae Yun Lim ),( Ju Yeon Choi ),( Jung In Kim ),( Jung Min ),( Joon Hong Min ),( Young Jun Choi ),( Jae Hui Nam ),( Ga Young Lee ),( Won Serk Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Penicillamine is a copper chelator, clinically used in the treatment of Wilson’s disease and rheumatoid arthritis. Long-term penicillamine therapy can induce cutaneous adverse events including acute hypersensitivity reactions, autoimmune disorders, and elastic fiber abnormalities. Penicillamine-induced dermopathy, characterized by milia, purpura, skin fragility and wrinkling of the skin, results from inhibition of elastic and collagen metabolism by high cumulative dose of penicillamine. A 54-year-old female presented with well-demarcated 4 to 6 cm sized brown patches with tiny white papules on the both lateral pelvic areas. Recurrent hemorrhagic blisters and skin fragility were also observed in the lesions. She had been diagnosed with Wilson’s disease and treated with daily dosage of 2 g of penicillamine for 7 years. The histological examination showed organizing crust with regenerating epidermis, band-like granulation tissue, and edematous fibrotic upper dermis.Vascular ectasia and RBC extravasation were prominent. Moreover, a specimen demonstrated multiple milia containing laminated keratin. For clinical aspects, the patient had to continue to take penicillamine. After 3 months from her initial visit, similar skin lesions were developed on the malleolar area and both knees, particularly over points of pressure. Consequently, a diagnosis of penicillamine-induce dermopathy was made on the basis of the clinical and histological features

Identification of hepatotoxicity related genes induced by toxaphene in HepG2 cells

Han-Saem Choi,김연정,Mee Song,송미경,류재천 대한독성 유전단백체 학회 2011 Molecular & cellular toxicology Vol.7 No.1

Toxaphene is a bioaccumulative, persistent,and toxic pollutant. Toxaphene is one of the 12 priority of Persistent Organic Pollutants (POPs) intended for global action by the United Nations Environment Program (UNEP) Governing Council. POPs are manmade synthetic chemicals highly resistant to biodegradation,with a high affinity for bioaccumulation (due to their hydrophobic and/or lipophilic nature) and biomagnification in the environment and living organisms,including humans. Once deposited in humans (mainly in adipose tissue), they form stable compounds that result in a lasting toxic body burden. Most human populations are exposed to mixtures of POPs originated either from local or remote sources. Toxaphene is ubiquitous in air, water, soil, and biological matrices,as well as in major environmental compartments. Toxaphene has effects on various organs such as thyroid,bone, skin, kidneys, and blood cells and especially,revealed strong toxicity to liver. In this study,we identified genes related to hepatotoxiciy induced by toxaphene in human hepatocellular carcinoma (HepG2) cells using microarray and gene ontology (GO) analysis. Through microarray analysis, we identified 1,647 up- and 2,251 down-regulated genes changed by more than 1.5-fold and P-values 0.001 by toxaphene. And after GO analysis, we determined several key pathways which known as related to hepatotoxicity such as MAPK signaling pathway, complement and coagulation cascades, tight junction. Thus, our present study suggests that genes expressed by toxaphene may provide a clue for hepatotoxic mechanism of toxaphene.

A case of the clinical and histological transition in lymphomatoid granulomatosis

( Han Saem Kim ),( Jung Yup Kim ),( Sun Min Lim ),( Jae Yun Lim ),( Ju Yeon Choi ),( Jung In Kim ),( Jung Min ),( Joon Hong Min ),( Young Jun Choi ),( Jae Hui Nam ),( Ga Young Lee ),( Won Serk Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Lymphomatoid granulomatosis (LYG) is a rare B-cell lymphoproliferative disorder, predominantly involving the lungs and skin. LYG is associated with Ebstein-Barr virus (EBV) and characterized by angiocentric and angiodestructive atypical lymphoid infiltrate. An 84-year-old female presented with widespread erythematous papules and nodules in the whole body. No generalized symptoms and specific findings on the physical examination were observed. The histological findings showed mild lymphohistiocytic infiltrate around superficial vessels and sweat glands. The lesions were improved with systemic glucocorticoids. However, the lesions were aggravated after discontinuation of glucocorticoids. To confirm the diagnosis, a skin biopsy was repeated and the specimen revealed more significant lymphocytic collections and granulomatous change than the previous findings, with some atypical lymphocytes presenting positivity of CD3 and CD20. Nine months after her initial visit, she complained of severe dyspnea and generalized edema, presenting diffuse consolidation and ground glass opacity on the lungs in chest CT. The skin lesions were coalescent into plaques, and a biopsy was retried. The biopsy revealed massive angiocentric atypical lymphoid cells, showing positivity of EBV in situ hybridization. In conclusion, LYG, grade 3 was diagnosed on the basis of the clinical course and histological patterns.

P073 Rosacea and its association with enteral microbiome and systemic diseases

( Han-saem Kim ),( Jung Yup Kim ),( Sunmin Yim ),( Jae Yun Lim ),( Ju-yeon Choi ),( Jung-in Kim ),( Jung Min ),( Ho Joo Jung ),( Joon Hong Min ),( Young Jun Choi ),( Jae Hui Nam ),( Ga-young Lee ),( W 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

<div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div> Background: Rosacea is a common chronic inflammatory skin disease. Recently, it is revealed that systemic diseases are associated with rosacea. Objectives: To investigate the relationship between gut microbiome, associated diseases and rosacea. Methods: A cross-sectional analysis was performed among healthy female subjects. Study data were obtained from 282 subjects who participated in a health check-up program. Rosacea was assessed by a questionnaire. Other medical illnesses were evaluated by thorough medical examination and history taking. Stool microbiota was analysed by QIIME (Quantitative Insights Into Microbial Ecology) software. Results: The study included 12 patients with rosacea and 270 subjects without rosacea (control group). After adjusting for age, body mass index (BMI) was significantly higher in rosacea patients as compared with the control group (odds ratio 1.20, 95% confidence interval 1.02-1.42). Seven metagenomic genera were correlated with rosacea: Peptococcaceae family unknown genus, Methanobrevibacter genus, Acidaminococcus genus, Megasphaera genus, Lactococcus genus, Eggerthella genus, Lactobacillales order unknown family unknown genus (p<0.05). Conclusion: This study shows that rosacea is associated with BMI and specific gut microbiota.

Identification of a novel point mutation in DAX-1 gene in a patient with adrenal hypoplasia congenita

Choi Han Saem,권아름,채현욱,Suh Junghwan,Song Kyung Chul,이진성,김호성 대한소아내분비학회 2021 Annals of Pediatirc Endocrinology & Metabolism Vol.26 No.2

X-linked adrenal hypoplasia congenita caused by a mutation in NR0B1/DAX-1 is a rare inherited disorder. Patients with adrenal hypoplasia congenita are usually diagnosed with primary adrenal insufficiency in infancy or early childhood and present hypogonadotropic hypogonadism during adolescence. Our patient first presented with adrenal crisis at the age of 2 months, which was managed with glucocorticoids and mineralocorticoids. At the age of 17 years, testicular volumes of 5 mL each and a stretched penile length of 4 cm were noted. A combined pituitary function test showed a peak luteinizing hormone level of 2.68 mIU/mL, testosterone 13.5 ng/dL, confirming hypogonadotropic hypogonadism. After whole-exome sequencing, a new variant of DAX-1, c.881T>C (p.Leu294Pro), was found. He was diagnosed with X-linked adrenal hypoplasia congenita and then treated with human choriogonadotropin for the induction of spermatogenesis as well as with steroid replacement therapy.

[P417] A case of rheumatoid neutrophilic dermatosis mimicking herpes simplex infection

( Han-saem Kim ),( Junghwa Yang ),( Yun Ho Lee ),( Jung Yup Kim ),( Sunmin Yim ),( Jae Yun Lim ),( Ju-yeon Choi ),( Joon Hong Min ),( Young Jun Choi ),( Jae-hui Nam ),( Ga-young Lee ),( Won-serk Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Rheumatoid arthritis (RA) is an autoimmune inflammatory disorder. Various cutaneous manifestations are associated with RA, including rheumatoid nodule, vasculitis, palisading granulomatous dermatitis, and neutrophilic disorders. Rheumatoid neutrophilic dermatitis (RND) occurs in patients with active and severe RA, and vesicular-type RND is rarely reported, which predominantly involves the lower extremities. A 66-year-old female presented a 6-year history of RA. She had successfully treated with the combination of systemic prednisolone and methotrexate. At the beginning of 2015, erythematous vesicles with crust and erosion suddenly began to spread symmetrically on the both thighs. The lesion was accompanied with intermittent pain. The patient was initially treated with oral acyclovir and a mid-potent topical steroid, based on the diagnosis of herpes simplex. The lesions, however, were recurrent every month despite taking medications. A year later, a skin biopsy was performed. The histological examination showed intracorneal pustules and dense dermal inflammatory infiltrates, consisting mainly of adundant neutrophils. There were endothelial swelling and luekocytoclasis, but no vasculitis. The patient was then started on leflunomide for the control of RA with satisfactory preliminary skin response. The based on the clinical and histological features, RND was diagnosed.