Adenocarcinoma Arising at a Urostomy: Case Report and Literature Review

Jeon Sungmi,Myung Yujin,Pak Changsik 대한창상학회 2020 Journal of Wound Management and Research Vol.16 No.2

We report a case of adenocarcinoma originating in a urostomy site 35 years after bladder cancer operation and urostomy formation. While ileostomy adenocarcinoma has been reported as a rare complication after colectomy and ileostomy formation for inflammatory bowel disease or familial adenomatous polyposis, there were no previously published cases of parastomal carcinoma in patients with urostomy. In our case, a series of work-ups, including immunohistochemical staining (cytokeratin 7 and 20, p63), revealed no evidence of primary adenocarcinoma of the skin or any other primary tumor. The patient underwent surgical excision with urostomy reformation and the skin defect was successfully reconstructed using local flap and split-thickness skin graft. This case poses a diagnostic challenge for clinicians because skin primary adenocarcinoma (i.e., malignant adnexal tumor) is likely to be ruled out due to its low incidence, and the symptoms may be considered those of a rare subcutaneous metastasis from a visceral malignancy (e.g., colon cancer) in the patient with a history of a prior malignancy (bladder cancer). This underscores the need for a multidisciplinary approach and patient education for early diagnosis.

Cranial base reconstruction and secondary frontal advancement for meningoencephalocele following Le Fort III osteotomy in a patient with Crouzon syndrome: case report

Jeon Sungmi,Kim Yumin,Phi Ji Hoon,Chung Jee Hyeok 대한성형외과학회 2023 Archives of Plastic Surgery Vol.50 No.1

Patients with Crouzon syndrome have increased risks of cerebrospinal fluid (CSF) rhinorrhea and meningoencephalocele after Le Fort III osteotomy. We report a rare case of meningoencephalocele following Le Fort III midface advancement in a patient with Crouzon syndrome. Over 10 years since it was incidentally found during transnasal endoscopic orbital decompression, the untreated meningoencephalocele eventually led to intermittent clear nasal discharge, frontal headache, and seizure. Computed topography (CT) and magnetic resonance (MR) imaging demonstrated meningoencephalocele in the left frontal-ethmoid-maxillary sinus through a focal defect of the anterior cranial base. Through bifrontal craniotomy, the meningoencepehalocele was removed and the anterior cranial base was reconstructed with a pericranial flap and split calvarial bone graft. Secondary frontal advancement was concurrently performed to relieve suspicious increased intracranial pressure, limit visual deterioration, and improve the forehead shape. Surgeons should be aware that patients with Crouzon syndrome have the potential for an unrecognized dural injury during Le Fort III osteotomy due to anatomical differences such as inferior displacement and thinning of the anterior cranial base.

Multiple Injections of Adipose-Derived Stem Cells Improve Graft Survival in Human-to-Rat Skin Xenotransplantation through Immune Modulation

Jeon Sungmi,Kim Iljin,Na Yi Rang,Yong Hong Ki,Chang Hak,Kim Seung Hwan,Jeong Yu Jin,Chung Jee Hyeok,Kim Sang Wha 한국조직공학과 재생의학회 2023 조직공학과 재생의학 Vol.20 No.6

BACKGROUND: Adipose-derived stem cells (ADSCs) exert immunomodulatory effects in the treatment of transplant rejection. This study aimed to evaluate the effects of ADSCs on the skin graft survival in a human-to-rat xenograft transplantation model and to compare single and multiple injections of ADSCs. METHODS: Full-thickness human skin xenografts were transplanted into the backs of Sprague–Dawley rats. The rats were injected subcutaneously on postoperative days 0, 3, and 5. The injections were as follows: triple injections of phosphate-buffered saline (PBS group), a single injection of ADSCs and double injections of PBS (ADSC 9 1 group), and triple injections of ADSCs (ADSC 9 3 group). The immunomodulatory effects of ADSCs on human skin xenografts were assessed. RESULTS: Triple injections of ADSCs considerably delayed cell-mediated xenograft rejection compared with the PBS and ADSC 9 1 groups. The vascularization and collagen type 1–3 ratios in the ADSC 9 3 group were significantly higher than those in the other groups. In addition, intragraft infiltration of CD3-, CD4-, CD8-, and CD68-positive cells was reduced in the ADSC 9 3 group. Furthermore, in the ADSC 9 3 group, the expression levels of proinflammatory cytokine interferon-gamma (IFN-c) were decreased and immunosuppressive prostaglandin E synthase (PGES) was increased in the xenograft and lymph node samples. CONCLUSION: This study presented that triple injections of ADSCs appeared to be superior to a single injection in suppressing cell-mediated xenograft rejection. The immunomodulatory effects of ADSCs are associated with the downregulation of IFN-c and upregulation of PGES in skin xenografts and lymph nodes.

Recent advances in the pathogenesis of microvascular complications in diabetes

Sungmi Park,Hyeon-Ji Kang,Jae-Han Jeon,Min-Ji Kim,In-Kyu Lee 대한약학회 2019 Archives of Pharmacal Research Vol.42 No.3

Millions of people worldwide have diabetes, which is diagnosed by fasting blood glucose levels exceeding 126 mg/dL. Regardless of the type of diabetes, prolonged hyperglycemia is damaging to several organs including eyes, kidneys, nerve, and/or heart. The damages are associated with a high risk of morbidity and mortality. Diabetes has been implicated in ischemia in the microvasculature of the target tissues, which occurs due to the insufficient perfusion of tissues. The resulting occlusion and pain affect the quality of life. Multiple therapeutic approaches have been proposed for a long time to overcome these vascular complications. Apart from systemically controlling high glucose levels, other therapeutic strategies are not well understood. In this review, we summarize the recent literature for biochemical/cellular targets that are being utilized for the treatment of diabetic microvascular diseases. These targets, which are closely associated with mitochondrial dysfunction, include the polyol and diacylglycerol-protein kinase C pathways, oxidative stress, non-enzymatic glycation and the formation of advanced glycation end products, and immune dysregulation/inflammation.

Scoparone interferes with STAT3-induced proliferation of vascular smooth muscle cells

Park, Sungmi,Kim, Jeong-Kook,Oh, Chang Joo,Choi, Seung Hee,Jeon, Jae-Han,Lee, In-Kyu Nature Publishing Group 2015 Experimental and molecular medicine Vol.47 No.3

<P>Scoparone, which is a major constituent of <I>Artemisia</I> capillaries, has been identified as an anticoagulant, hypolipidemic, vasorelaxant, anti-oxidant and anti-inflammatory drug, and it is used for the traditional treatment of neonatal jaundice. Therefore, we hypothesized that scoparone could suppress the proliferation of VSMCs by interfering with STAT3 signaling. We found that the proliferation of these cells was significantly attenuated by scoparone in a dose-dependent manner. Scoparone markedly reduced the serum-stimulated accumulation of cells in the S phase and concomitantly increased the proportion of cells in the G0/G1 phase, which was consistent with the reduced expression of cyclin D<SUB>1</SUB>, phosphorylated Rb and survivin in the VSMCs. Cell adhesion markers, such as MCP-1 and ICAM-1, were significantly reduced by scoparone. Interestingly, this compound attenuated the increase in cyclin D promoter activity by inhibiting the activities of both the WT and active forms of STAT3. Similarly, the expression of a cell proliferation marker induced by PDGF was decreased by scoparone with no change in the phosphorylation of JAK2 or Src. On the basis of the immunofluorescence staining results, STAT3 proteins phosphorylated by PDGF were predominantly localized to the nucleus and were markedly reduced in the scoparone-treated cells. In summary, scoparone blocks the accumulation of STAT3 transported from the cytosol to the nucleus, leading to the suppression of VSMC proliferation through G1 phase arrest and the inhibition of Rb phosphorylation. This activity occurs independent of the form of STAT3 and upstream of kinases, such as Jak and Src, which are correlated with abnormal vascular remodeling due to the presence of an excess of growth factors following vascular injury. These data provide convincing evidence that scoparone may be a new preventative agent for the treatment of cardiovascular diseases.</P>

Successful Treatment of a Large Coccygeal Pressure Ulcer Using Injectable Acellular Dermal Matrix: A Case Report

Kim Minseo,Jeon Sungmi,Kim Sang Wha 대한창상학회 2021 Journal of Wound Management and Research Vol.17 No.3

Pressure sores are common but troublesome for both patients and clinicians. They can range from mild to severe and must be managed accordingly. Despite advancements in both non-surgical and surgical intervention, no standard treatment protocol has yet been established. Since pressure sores can occur in a variety of clinical settings, treatment must be individualized to the patient’s circumstances. Recently, acellular dermal matrix (ADM) has been utilized as an alternative treatment for non-healing wounds. In the present report, we describe the case of a non-ambulatory patient in whom a large pressure sore located near the anus was completely cured using CG paste, an injectable ADM.

Management of Coccygeal Radiation-Induced Ulcer Using Injectable Acellular Dermal Matrix Combined with Negative Pressure Wound Therapy: A Case Report

Kim Minseo,Jeon Sungmi,Kim Sang Wha 대한창상학회 2022 Journal of Wound Management and Research Vol.18 No.1

Radiation ulcers can occur as a complication following exposure to ionizing radiation. Advances in medical technology, followed by the wider range of radiation application in recent decades has steadily increased the incidence of radiation ulcers. Radiation causes hypoxia, hypovascularity, and hypocellularity in tissues. Moreover, the surrounding skin adjacent to the radiation ulcer lacks follicular stem cells and is more prone to chronic, non-healing wounds. While no guidelines have been established regarding optimal treatment, management facilitating angiogenesis and migration of fibrogenic cells can be a recommended option, considering the etiology of ulcers induced by radiation exposure. Herein, we present a patient exposed to prolonged radiation during a fluoroscopic intervention procedure, who had developed a vast radiation ulcer at his coccyx, and was completely treated with injectable acellular dermal matrix combined with 14 weeks of negative pressure wound therapy.

신경 섬유종증 1형 환자의 양측 후두 신경통: 증례보고

김지영(Ji-Young Kim),전성미(Sungmi Jeon),김상화(Sang Wha Kim) 대한두경부종양학회 2021 대한두경부 종양학회지 Vol.37 No.2

Plexiform neurofibromas (PNFs) represent an uncommon variant (30%) of neurofibromatosis type 1 (NF-1), in which neurofibromas arise from multiple nerves as bulging and deforming masses involving connective tissue and skin folds. We report the case of a 17-year-old man with known NF-1 presenting with bilateral occipital neuralgia that began in his late adolescence. His chief complaint was radiating pain in the occiput induced by protective helmet wear when riding alpine skiing. Craniofacial magnetic resonance imaging (MRI) confirmed the presence of fusiform masses arising from the bilateral greater occipital nerves. Histopathological examination of the biopsy samples showed PNFs. After surgical treatment, the patient s symptoms completely improved. Unlike cutaneous neurofibromas, PNFs have different clinical characteristics and have the risk of malignant mutations. Correct diagnosis and adequate surgical treatment are necessary for PNFs.

Pyruvate dehydrogenase kinase 4 deficiency attenuates cisplatin-induced acute kidney injury

Oh, Chang Joo,Ha, Chae-Myeong,Choi, Young-Keun,Park, Sungmi,Choe, Mi Sun,Jeoung, Nam Ho,Huh, Yang Hoon,Kim, Hyo-Jeong,Kweon, Hee-Seok,Lee, Ji-min,Lee, Sun Joo,Jeon, Jae-Han,Harris, Robert A.,Park, Keu Springer-Verlag 2017 Kidney international Vol.91 No.4

<P>Clinical prescription of cisplatin, one of the most widely used chemotherapeutic agents, is limited by its side effects, particularly tubular injury-associated nephrotoxicity. Since details of the underlying mechanisms are not fully understood, we investigated the role of pyruvate dehydrogenase kinase (PDK) in cisplatin-induced acute kidney injury. Among the PDK isoforms, PDK4 mRNA and protein levels were markedly increased in the kidneys of mice treated with cisplatin, and c-Jun N-terminal kinase activation was involved in cisplatin-induced renal PDK4 expression. Treatment with the PDK inhibitor sodium dichloroacetate (DCA) or genetic knockout of PDK4 attenuated the signs of cisplatin-induced acute kidney injury, including apoptotic morphology of the kidney tubules along with numbers of TUNEL-positive cells, cleaved caspase-3, and renal tubular injury markers. Cisplatin-induced suppression of the mitochondria! membrane potential, oxygen consumption rate, expression of electron transport chain components, cytochrome c oxidase activity, and disruption of mitochondrial morphology were noticeably improved in the kidneys of DCA-treated or PDK4 knockout mice. Additionally, levels of the oxidative stress marker 4-hydroxynonenal and mitochondria! reactive oxygen species were attenuated, whereas superoxide dismutase 2 and catalase expression and glutathione synthetase and glutathione levels were recovered in DCA-treated or PDK4 knockout mice. Interestingly, lipid accumulation was considerably OCrossMark attenuated in DCA-treated or PDK4 knockout mice via recovered expression of peroxisome proliferator-activated receptor-a and coactivator PGC-1 alpha, which was accompanied by recovery of mitochondria! biogenesis. Thus, PDK4 mediates cisplatin-induced acute kidney injury, suggesting that PDK4 might be a therapeutic target for attenuating cisplatin-induced acute kidney injury.</P>