• 동의생리병리학회지
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• 제35권6호
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• pp.255-260
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• 2021

Crohn's disease (CD) is an idiopathic inflammatory bowel disease (IBD) with unknown etiopathogenesis. Currently there are no definitive treatment modalities for CD. This case report presents clinical remission and its maintenance of CD induced by Korean herbal medicine treatment. A 56-year-old male patient diagnosed as CD by capsule endoscopy presented to a Korean Medicine clinic with severe abdominal pain as a chief complaint. Despite taking 5-aminosalicylic acid and immunosuppressant for 2 years, his abdominal pain was worsening at the time of visit. Treatment was initiated with Jinmoo-tang based on pattern identification and continued for approximately a year with some modifications according to patient's symptom changes. He was mainly given Jinmoo-Tang for a year and clinical remission was achieved; he could stop taking western medications. For 6 years since then, he took Korean medicine from time to time when he felt his condition went down and he is still maintaining remission. There were no adverse events reported. This case report suggests that individualized Korean herbal medicine treatment may have the potential for induction and maintenance of clinical remission of CD. Further research is warranted to establish an evidence-base for such approach.

• International Journal of Oral Biology
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• 제46권4호
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• pp.190-199
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• 2021

Despite evidence that bacteria-sensing Toll-like receptors (TLRs) are activated in salivary gland tissues of Sjogren syndrome (SS) patients, the role of oral bacteria in SS etiopathogenesis is unclear. We previously reported that two SS-associated oral bacteria, Prevotella melaninogenica (Pm) and Rothia mucilagenosa (Rm), oppositely regulate the expression of major histocompatibility complex class I (MHC I) in human salivary gland (HSG) cells. Here, we elucidated the mechanisms underlying the differential regulation of MHC I expression by these bacteria. The ability of Pm and Rm to activate TLR2, TLR4, and TLR9 was examined using TLR reporter cells. HSG cells were stimulated by the TLR ligands, Pm, and Rm. The levels of MHC I expression, bacterial invasion, and viability of HSG cells were examined by flow cytometry. The hypoxic status of HSG cells was examined using Hypoxia Green. HSG cells upregulated MHC I expression in response to TLR2, TLR4, and TLR9 activation. Both Pm and Rm activated TLR2 and TLR9 but not TLR4. Rm-induced downregulation of MHC I strongly correlated with bacterial invasion and cell death. Rm-induced cell death was not rescued by inhibitors of the diverse cell death pathways but was associated with hypoxia. In conclusion, Pm upregulated MHC I likely through TLR2 and TLR9 activation, while Rm-induced hypoxia-associated cell death and the downregulation of MHC I, despite its ability to activate TLR2 and TLR9. These findings may provide new insight into how oral dysbiosis can contribute to salivary gland tissue damage in SS.

• Journal of Oral Medicine and Pain
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• 제35권1호
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• pp.41-47
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• 2010

구강작열감증후군은 임상적 증상이나 검사실 소견없이 구강점막에 나타나는 작열감을 말하며 중년이후 폐경기 여성에게 높은 발생율을 보인다. 구강작열감증후군에서 보여지는 통증은 자발적이며 뚜렷한 악화요인을 보이고 있지 않다. 통증 유발과 관련해서 치과적 술식, 최근의 질환, 투약(항생제 요법)등을 포함하고 있으며, 작열감이 한 번 시작되면 수년간 지속된다. 대부분의 구강작열감 환자는 국소적 또는 전신적 요인을 가지고 있으며, 구강작열감증후군은 신경병리학적 활성화에서 기원되는 만성구강증상으로 고려할 수 있으며, 정신학적 원인에 대한 역할은 아직은 명확하지 않다. 구강작열감의 신경학적 측면에 대하여 연구가 증가하고 있고 이런 연구는 구강작열감에 중추신경계, 말초신경계가 관여함을 제시하고 있다. 그 중에 하나로 대두 되고 있는 것이 미각에서의 이상이 존재한다는 것이다. 구강작열감증후군에서 supertaster의 존재에 대해 언급하고 있으며, 이는 미각과 유해수용성 기전에 상호작용함을 제시하고 있다. 즉 중추신경계에서 미각과 구강 통증 감각이 연결되어 있고 이것은 구강작열감증후군에서 고삭신경, 설인신경수준에서 미각체계 변형에 의한 말초신경계와 중추신경계가 같이 상호 작용하여 구강작열감증후군을 발생시킴을 보여준다. 이에 본 저자는 만성구강통증으로 여겨지는 구강작열감증후군을 유발하는 요인과 병태 생리를 고찰하여 환자의 진단과 원인 지향적인 치료에 도움을 주고자 한다.

• IMMUNE NETWORK
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• 제3권3호
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• pp.201-210
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• 2003

Objective: The role of prostaglandin $E_2$ (PGE2) in the etiopathogenesis of immune and inflammatory diseases has become the subject of recent debate. To determine the role of PGE2 in rheumatoid arthritis (RA), we tested the effect of exogenous PGE2 on the production of cyclooxygenase-2 (COX-2) by rheumatoid synoviocytes. Methods: Fibroblast-like synoviocytes (FLS) were prepared from the synovial tissues of RA patients, and cultured in the presence of PGE2. The COX-2 mRNA and protein expression levels were determined by RT-PCR and Western blot analysis, respectively. The PGE2 receptor subtypes in the FLS were analyzed by RT-PCR. Electrophoretic mobility shift assay (EMSA) was used to measure the NF-${\kappa}B$ binding activity for COX-2 transcription. The in vivoeffect of PGE2 on the development of arthritis was also tested in collagen induced arthritis (CIA) animals. Results: PGE2 ($10^{-11}$ to $10^{-5}M$) dose-dependently inhibited the expression of COX-2 mRNA and the COX-2 protein stimulated with IL-$1{\beta}$, but not COX-1 mRNA. NS-398, a selective COX-2 inhibitor, displayed an additive effect on PGE2-induced COX-2 downregulation. The FLS predominantly expressed the PGE2 receptor (EP) 2 and EP4, which mediated the COX-2 suppression by PGE2. Treatment with anti-IL-10 monoclonal antibodies partially reversed the PGE2-induced suppression of COX-2 mRNA, suggesting that IL-10 may be involved in modulating COX-2 by PGE2. Experiments using an inducer and an inhibitor of cyclic AMP (cAMP) suggest that cAMP is the major intracellular signal that mediates the regulatory effect of PGE2 on COX-2 expression. EMSA revealed that PGE2 inhibited the binding of NF-${\kappa}B$ in the COX-2 promoter via a cAMP dependent pathway. In addition, a subcutaneous injection of PGE2 twice daily for 2 weeks significantly reduced the incidence and severity of CIA as well as the production of IgG antibodies to type II collagen. Conclusion: Our data suggest that overproduced PGE2 in the RA joints may function as an autocrine regulator of its own synthesis by inhibiting COX-2 production and may, in part, play an anti-inflammatory role in the arthritic joints.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권2호
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• pp.108-120
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• 2004

Object : Patients with facial asymmetry accompanying mandibular prognathism have various causes and clinical features. So, it is difficult to find a satisfactory treatment method functionally and esthetically. Every traditional classification and interpretation to find etiopathogenesis and/or to establish ideal surgical modality has many limitations because it can't be applied simply to various conditions of patients with facial asymmetry accompanying mandibular prognathism. Therefore, we employ a new classification to interpret more details of the morphologic change of mandible and the spatial change of mandible and maxilla. Materials and Methods : Using panoramic X-ray films, PA cephalograms and submentovertex films of 126 patients diagnosed with facial asymmetry accompanying mandibular prognathism as resources, the following results were gathered after analyzing each characteristics through distributing the patterns according to the morphological mandibular asymmetry and mandibular and maxillary spatial asymmetry. Results : Almost frequency of morphological mandibular asymmetry was shown. In case of condyle-ramus elongation and body elongation group, it's frequency was the highest. Higher frequency of compensating vertical growth was shown on the side of over growing maxilla in case of vertical length difference between left and right condyle-ramus. On the other hand, higher frequency of no compensating vertical growth difference between left and right side was shown in case of no vertical length difference in condyle-ramus. Spatial mandibular asymmetry generally occurred when there was no morphological mandibular asymmetry. Correlation between condyle length difference and condyle-ramus length difference between left and right side was very high, but correlation between condyle length difference and body length difference, and correlation between condyle length difference and body vertical length difference was low. Conclusion : In case of patients with facial asymmetry accompanying mandibular prognathism, it is suggested that various pattern of facial asymmetry is occurred by the independent growth of each unit rather than dependent growth of other unit by major growth unit abnormality. Due to the untypical pattern and the various asymmetry occurring according to the changes of each mandibular growth unit, it is considered that an appropriate surgical method should be searched based on the accurate recognition of the each pattern for patients with facial asymmetry accompanying mandibular prognathism.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1317-1320
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• 2012

Biliary tract cancers, broadly described as malignancies that arise from the biliary tract epithelia, are usually divided into two major clinical phenotypes: cholangiocarcinoma and gallbladder cancer, differing in etiopathogenesis, risk factors, and perhaps molecular and genetic signatures. Atypical symptoms and lack of tumor biomarkers make it difficult to diagnose in early stages. At the time of presentation, few patients are candidates for potentially curative surgical resection. We here assessed and compared features of a total of 150 cases divided into extra- and intrahepatic cholangiocarcinomas and gallbladder cancers (GBC). Althought there were no significant differences in serum tumour marker levels, GBC patients had the poorest prognosis. Furthermore, gallbladder cancer respond poorly to chemotherapy or radiation therapy and approximately half of untreated patients died within 10 months. Therefore, treatment for patients with gallbladder cancer is still in challenge. Outcomes and survival of these patients had improved little over the past three decades - a period in which new successful treatments have greatly contributed to the prolonged patient survival for many other cancers.

• 대한소아치과학회지
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• 제48권4호
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• pp.476-483
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• 2021

외상성 골낭은 임상 증상이 없으며 청소년기에 호발 한다. 주로 정기검진을 위한 파노라마 촬영시에 우연히 발견되며 병소는 비교적 경계가 뚜렷한 단일성의 방사선 투과상으로 가리비 껍질 모양의 변연을 보인다. 조직학적 소견으로 해면골내 공동과 얇고 느슨한 결합조직의 이장이 관찰된다. 상피세포의 이장이 존재하지 않는 것이 주된 조직학적 특징이다. 호발 부위는 하악 견치부와 제3대구치 사이이다. 하악 결합 부위에서는 드물게 나타난다. 외상성 골낭의 발병원인은 아직 명확하지 않다. 외상성 골낭은 외과적 적출술과 소파술로 치료되며 외과적인 처치 후 6 - 12 개월 정도 지나면 새로운 골로 채워진다. 대부분의 케이스에서 치료 전 외상성 골낭으로 진단 내리는 것은 한계가 있다. 따라서 본 증례에서는 방사선학적, 조직학적 검사를 통해 진단 내렸다. 두 환자 모두 외상 관련 병력은 없었다. 외과적 처치 후 파노라마와 CBCT를 이용하여 골성 치유를 확인하였다.

• Childhood Kidney Diseases
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• 제4권1호
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• pp.33-39
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• 2000

목 적 : IgA 신병증은 혈뇨와 단백뇨를 보이는 사구체 질환으로 세계적으로 가장 빈도가 높은 질환중의 하나 이며 우리 나라를 포함한 아시아 지역에서도 높은 발생율을 보이고 있으나 아직 정확한 발생기전이나 원인은 불분명한 상태이다. IgA 신병증은 발병 10년 후 $20-30\%$가 말기 신부전증으로 진행됨이 보고되고 있으나 신부전으로 진행속도는 환자에 따라 매우 다양하기 때문에 특이적인 조직적합항원을 찾아냄으로서 치료 및 예후 결정에 도움을 주기 위하여 본 연구를 시행하였다. 대상 및 방법 : 세브란스 병원에 입원하여 IgA 신병증으로 진단 받은 환자를 대상으로 정상 신기능을 유지하고 있었던 소아환아 69명(Group A)과 이미 신부전으로 진행하여 신이식을 시행 받은 70명(Group B)을 포함한 신기능 저하군으로 분류하여 HLA대립유전자의 결정은 SSOP (sequence specific oligonucleotide probe)법으로 분석하여 HLA-class II(DR, DQ)대립유전자의 발현빈도와 IgA 신병증의 예후와의 관계를 분석하였다. 결 과 : 대상 환자의 진단 당시의 평균나이는 A군은 $8.8{\pm}2.9$세, B군은 $35.0{\pm}15.5$세였고, 남녀비는 각각 2.8:1과 2.5:1이었다. HLA-DQB1 유전자중 139명중 $47.5\%$로 $03^{**}$의 발현빈도가 가장 증가되어 있었고 $06^{**}(32.4\%),\;04^{**}(28.7\%),\;05^{**}(20.1\%),\;02^{**}(8.6\%)$순이 었다. DQ7의 HLA-DQB1*0301 이 전체 환자의 20.1$\%$(28/139)로 가장 흔한 대립유전자였으나 두군간에 유의한 차이는 없었다. 대립유전자중 HㄴA-$DQBI^*03^{**}과\;DQB1^*05^{**}$가 이미 말기신부전으로 진행된 Group B에서 유의하게 증가되어 있었으며(P<0.05), $03^{**}$ 아형중 $DQB1^{*}0302와\;05^{**}중\;DQB1^{*}05031$이 신기능이 정상인 A군에 비해 유의하게 증가되어 있었다(P<0.05). DR 유전자형의 low-frequency type상 HLA-$DRB1^*03과\;HLA-DRB1^*15$가 Group B에서 유의 있게 증가되어 있었으나, high-frequency type상에서는 양군 사이에 유의한 차이가 없었다. A군의 경우 신조직 검사의 소견에 따라 4등급으로 분류하여 대립유전자의 발현빈도를 분석하였으나 의미 있는 관계가 없었다. 곁 론 : IgA신병증의 예후를 예측하기 위한 여러 조사에서 발병 초기의 심한 단백뇨, 고혈압, 조직 병리학상의 심한 변화 등이 있을 경우 예후가 나쁘다고 하였으며 이런 위험 인자외에 유전적 요인에 대해 알아보고자 하였다. 본 연구에서 신부전으로 진행하여 신대체요법을 받은 IgA신병증환자군에서 HLA-$DQB1^*0302와\;^*05031$ 대립유전자의 발현빈도가 유의하게 증가되어 있어 이 결과를 바탕으로 치료후의 경과 및 예후를 진단초기에 예측하여 환자의 관리에 적용할수 있는 중요한 자료로 이용될 수 있을 것으로 사료된다.