1.Human Understanding is Expected of the Physician: Proposing a Model of Disease Development
Sang-Heum PARK ; Samel PARK ; Jin Young KIM ; Hyeon Ah LEE ; Sang Mi LEE ; Tae Hoon LEE ; Sang Byung BAE ; Sung Hae CHANG ; Si Hyong JANG ; Sung Wan CHUN ; Jong Ho MOON
Korean Journal of Medicine 2025;100(1):44-
2.Human Understanding is Expected of the Physician: Proposing a Model of Disease Development
Sang-Heum PARK ; Samel PARK ; Jin Young KIM ; Hyeon Ah LEE ; Sang Mi LEE ; Tae Hoon LEE ; Sang Byung BAE ; Sung Hae CHANG ; Si Hyong JANG ; Sung Wan CHUN ; Jong Ho MOON
Korean Journal of Medicine 2025;100(1):44-
3.Human Understanding is Expected of the Physician: Proposing a Model of Disease Development
Sang-Heum PARK ; Samel PARK ; Jin Young KIM ; Hyeon Ah LEE ; Sang Mi LEE ; Tae Hoon LEE ; Sang Byung BAE ; Sung Hae CHANG ; Si Hyong JANG ; Sung Wan CHUN ; Jong Ho MOON
Korean Journal of Medicine 2025;100(1):44-
4.Human Understanding is Expected of the Physician: Proposing a Model of Disease Development
Sang-Heum PARK ; Samel PARK ; Jin Young KIM ; Hyeon Ah LEE ; Sang Mi LEE ; Tae Hoon LEE ; Sang Byung BAE ; Sung Hae CHANG ; Si Hyong JANG ; Sung Wan CHUN ; Jong Ho MOON
Korean Journal of Medicine 2025;100(1):44-
5.Progressive tooth pattern changes in Cilk1-deficient mice depending on Hedgehog signaling.
Minjae KYEONG ; Ju-Kyung JEONG ; Dinuka ADASOORIYA ; Shiqi KAN ; Jiwoo KIM ; Jieun SONG ; Sihyeon PARK ; Suyeon JE ; Seok Jun MOON ; Young-Bum PARK ; Hyuk Wan KO ; Eui-Sic CHO ; Sung-Won CHO
International Journal of Oral Science 2025;17(1):71-71
Primary cilia function as critical sensory organelles that mediate multiple signaling pathways, including the Hedgehog (Hh) pathway, which is essential for organ patterning and morphogenesis. Disruptions in Hh signaling have been implicated in supernumerary tooth formation and molar fusion in mutant mice. Cilk1, a highly conserved serine/threonine-protein kinase localized within primary cilia, plays a critical role in ciliary transport. Loss of Cilk1 results in severe ciliopathy phenotypes, including polydactyly, edema, and cleft palate. However, the role of Cilk1 in tooth development remains unexplored. In this study, we investigated the role of Cilk1 in tooth development. Cilk1 was found to be expressed in both the epithelial and mesenchymal compartments of developing molars. Cilk1 deficiency resulted in altered ciliary dynamics, characterized by reduced frequency and increased length, accompanied by downregulation of Hh target genes, such as Ptch1 and Sostdc1, leading to the formation of diastemal supernumerary teeth. Furthermore, in Cilk1-/-;PCS1-MRCS1△/△ mice, which exhibit a compounded suppression of Hh signaling, we uncovered a novel phenomenon: diastemal supernumerary teeth can be larger than first molars. Based on these findings, we propose a progressive model linking Hh signaling levels to sequential changes in tooth patterning: initially inducing diastemal supernumerary teeth, then enlarging them, and ultimately leading to molar fusion. This study reveals a previously unrecognized role of Cilk1 in controlling tooth morphology via Hh signaling and highlights how Hh signaling levels shape tooth patterning in a gradient-dependent manner.
Animals
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Hedgehog Proteins/physiology*
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Mice
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Signal Transduction/physiology*
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Tooth, Supernumerary
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Molar
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Cilia/physiology*
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Odontogenesis/physiology*
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Patched-1 Receptor
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Protein Serine-Threonine Kinases/physiology*
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Mice, Knockout
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Adaptor Proteins, Signal Transducing
6.Human Understanding is Expected of the Physician: Proposing a Model of Disease Development
Sang-Heum PARK ; Samel PARK ; Jin Young KIM ; Hyeon Ah LEE ; Sang Mi LEE ; Tae Hoon LEE ; Sang Byung BAE ; Sung Hae CHANG ; Si Hyong JANG ; Sung Wan CHUN ; Jong Ho MOON
Korean Journal of Medicine 2024;99(2):84-95
In Harrison’s Principles of Internal Medicine, human understanding is emphasized as one of three necessary characteristics that a physician must have. Inflammation, which is caused by inflammatory inducers (inf-ids), is a fundamental feature of disease at the cellular and molecular levels. Inflammation protects the body, but excessive or prolonged inflammation can be damaging and can cause disease. Humans are repeatedly exposed to external and internal environmental factors that generate inf-ids throughout their lives. External environmental factors include microbial and non-microbial inf-ids, as well as stressors that inevitably arise during social interactions. Internal environmental factors include the adaptive physiological response that is present from birth. Inf-ids may also be produced by the four-step habit loop, which consists of a cue (e.g., stressor), emotions, routine act (adaptive response), and a reward. Immune cells in the circulatory system and in tissues may have positive and negative effects in inflammatory responses. However, low-grade inflammation may be difficult to detect. We propose a model of disease development that integrates external and internal environmental factors from the perspective of human understanding.
7.Human Understanding is Expected of the Physician: Proposing a Model of Disease Development
Sang-Heum PARK ; Samel PARK ; Jin Young KIM ; Hyeon Ah LEE ; Sang Mi LEE ; Tae Hoon LEE ; Sang Byung BAE ; Sung Hae CHANG ; Si Hyong JANG ; Sung Wan CHUN ; Jong Ho MOON
Korean Journal of Medicine 2024;99(2):84-95
In Harrison’s Principles of Internal Medicine, human understanding is emphasized as one of three necessary characteristics that a physician must have. Inflammation, which is caused by inflammatory inducers (inf-ids), is a fundamental feature of disease at the cellular and molecular levels. Inflammation protects the body, but excessive or prolonged inflammation can be damaging and can cause disease. Humans are repeatedly exposed to external and internal environmental factors that generate inf-ids throughout their lives. External environmental factors include microbial and non-microbial inf-ids, as well as stressors that inevitably arise during social interactions. Internal environmental factors include the adaptive physiological response that is present from birth. Inf-ids may also be produced by the four-step habit loop, which consists of a cue (e.g., stressor), emotions, routine act (adaptive response), and a reward. Immune cells in the circulatory system and in tissues may have positive and negative effects in inflammatory responses. However, low-grade inflammation may be difficult to detect. We propose a model of disease development that integrates external and internal environmental factors from the perspective of human understanding.
8.Human Understanding is Expected of the Physician: Proposing a Model of Disease Development
Sang-Heum PARK ; Samel PARK ; Jin Young KIM ; Hyeon Ah LEE ; Sang Mi LEE ; Tae Hoon LEE ; Sang Byung BAE ; Sung Hae CHANG ; Si Hyong JANG ; Sung Wan CHUN ; Jong Ho MOON
Korean Journal of Medicine 2024;99(2):84-95
In Harrison’s Principles of Internal Medicine, human understanding is emphasized as one of three necessary characteristics that a physician must have. Inflammation, which is caused by inflammatory inducers (inf-ids), is a fundamental feature of disease at the cellular and molecular levels. Inflammation protects the body, but excessive or prolonged inflammation can be damaging and can cause disease. Humans are repeatedly exposed to external and internal environmental factors that generate inf-ids throughout their lives. External environmental factors include microbial and non-microbial inf-ids, as well as stressors that inevitably arise during social interactions. Internal environmental factors include the adaptive physiological response that is present from birth. Inf-ids may also be produced by the four-step habit loop, which consists of a cue (e.g., stressor), emotions, routine act (adaptive response), and a reward. Immune cells in the circulatory system and in tissues may have positive and negative effects in inflammatory responses. However, low-grade inflammation may be difficult to detect. We propose a model of disease development that integrates external and internal environmental factors from the perspective of human understanding.
9.Human Understanding is Expected of the Physician: Proposing a Model of Disease Development
Sang-Heum PARK ; Samel PARK ; Jin Young KIM ; Hyeon Ah LEE ; Sang Mi LEE ; Tae Hoon LEE ; Sang Byung BAE ; Sung Hae CHANG ; Si Hyong JANG ; Sung Wan CHUN ; Jong Ho MOON
Korean Journal of Medicine 2024;99(2):84-95
In Harrison’s Principles of Internal Medicine, human understanding is emphasized as one of three necessary characteristics that a physician must have. Inflammation, which is caused by inflammatory inducers (inf-ids), is a fundamental feature of disease at the cellular and molecular levels. Inflammation protects the body, but excessive or prolonged inflammation can be damaging and can cause disease. Humans are repeatedly exposed to external and internal environmental factors that generate inf-ids throughout their lives. External environmental factors include microbial and non-microbial inf-ids, as well as stressors that inevitably arise during social interactions. Internal environmental factors include the adaptive physiological response that is present from birth. Inf-ids may also be produced by the four-step habit loop, which consists of a cue (e.g., stressor), emotions, routine act (adaptive response), and a reward. Immune cells in the circulatory system and in tissues may have positive and negative effects in inflammatory responses. However, low-grade inflammation may be difficult to detect. We propose a model of disease development that integrates external and internal environmental factors from the perspective of human understanding.
10.Epigenome-wide Association Study for Tic Disorders in Children:A Preliminary Study in Korean Population
Young Kyung KO ; Suhyuk CHI ; Gyu-Hwi NAM ; Kyung-Wan BAEK ; Kung AHN ; Yongju AHN ; June KANG ; Moon-Soo LEE ; Jeong-An GIM
Clinical Psychopharmacology and Neuroscience 2024;22(2):295-305
Objective:
Tic disorders can affect the quality of life in both childhood and adolescence. Many factors are involved in the etiology of tic disorders, and the genetic and epigenetic factors of tic disorders are considered complex and heterogeneous.
Methods:
In this study, the differentially methylated regions (DMRs) between normal controls (n = 24; aged 6−15; 7 females) and patients with tic disorders (n = 16; aged 6−15; 5 females) were analyzed. We performed an epigenome-wide association study of tic disorders in Korean children. The tics were assessed using Yale Global Tic Severity Scale. The DNA methylation data consisted of 726,945 cytosine phosphate guanine (CpG) sites, assessed using the Illumina Infinium MethylationEPIC (850k) BeadChip. The DNA methylation data of the 40 participants were retrieved, and DMRs between the four groups based on sex and tic disorder were identified. From 28 male and 16 female samples, 37 and 38 DMRs were identified, respectively. We analyzed the enriched terms and visualized the network, heatmap, and upset plot.
Results:
In male, Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed hypomethylated patterns in the ligand, receptor, and second signal transductors of the PI3K-Akt and MAPK signaling pathway (most cells were indicated as green color), and in female, the opposite patterns were revealed (most cells were indicated as red color). Five mental disorder-related enriched terms were identified in the network analysis.
Conclusion
Here, we provide insights into the epigenetic mechanisms of tic disorders. Abnormal DNA methylation patterns are associated with mental disorder-related symptoms.

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