선천성 골 조갑 이형성증 : A Case Report 1례 보고

황규광,이원각,김동헌 건국대학교 의과학연구소 1993 건국의과학학술지 Vol.3 No.-

The Onycho-osteodysplasia is characterized anomalies of nails associated various skeletal dysplasia-knee, pelvis, elbow and others. The condition is usually transmitted as a simple autosomal dominant gene. The authors experienced one case of Onycho-osteo dysplasia showing dystropies of mails and hypoplastic patellae in a 4-year-old boy.

점액낭종에서 Sodium Morrhuate 응고술의 치료효과에 관한 연구

황규광 梨花女子大學校 醫科大學 醫科學硏究所 1997 EMJ (Ewha medical journal) Vol.20 No.1

목 적: 점액낭종에서 간단한 수술방법 혹은 일차적 접근방법으로 응고술을 임상적으로 이용할 수 있는지 알고자 5% sodium morrhuate와 같은 응고기제를 이용, 응고술을 시행하여 그 치료 성적을 평가하였다. 방 법: 1994년 1년간 15예의 점액 낭종에서 5% sodium morrhuate 응고술을 시행하여 11예가 추적 관찰되었다. 시술 방법은 우선 점액 낭종을 2~3mm 절개한 후, 수차례 세척한다. 5% sodium morrhuate가 최대한 낭종벽과 접촉시키기 위해 5분 이상에 걸쳐 천천히, 구석구석 주입한다. 시술후 탄력 붕대로 2~3일 압박 드레싱한다. 결 과: 환자의 나이는 12세부터 44세 까지 분포하였으며 발생 부위는 손목 7예, 엄지 2예, 귀 1예, 손 1예이었다. 임상 평가로써 총 11명중 5명에서 완치되어 45%의 완치율을 보였으며 재발율을 보면 총 11명중 6명(55%)의 환자에서 재발되었으며 재발된 시기는 2~3일부터 4개월까지 분포하여 시술후 평균 40일경이었다. 환자의 평가에 따른 치료 만족도는 총 대상 환자 11명중 우수 2명, 양호 1명, 보통 1명, 불량 7명이었다. 부작용은 총 11명중 3명에서 5건에서 경한 동통, 주입부위 경화, 색조 변화 등을 호소하였는데 금기 요건이 될 만한 심각한 경우는 없었으며 시간이 지남에 따라 점차 호전되었다. 결 론: 결절종을 포함한 점액낭종에서 절제술후 동통 등 합병증, 봉합의 미용상 문제 및 비교적 흔한 재발이 문제되므로, 절제술전에 비교적 간단한 시술인 응고술을 일차적 치료로 시도할 만한 방법이며, 응고술의 반복, 응고기제의 변경과 압박 방법의 개선을 통하여 지료효과를 훨씬 더 향상시킬 것으로 기대된다. Objective : The purpose of this study is to evaluate the therapeutic effect and clinical applicability of 5% sodium morrhuate sclerotherapy as primary surgical approach in cases of mucous systs. Material & methods : 15 cases of mucous cysts who were treated with 5% sodium morrhuate sclerotherapy were evaluated and 11 cases were followed up during 1994's. First, mucous cyst was incised, and washed out several times. 5% sodium morrhuate was infused slowly(More than 5 minutes) and throughly for maximal contact. Pressure dressing was done with elastic bandage for 2-3 days. Results : Age of patients were distributed form 12 year-old to 44 year-old. Involved sites were wrist97), thumb(2), ear(1), and hand(1). 5 cases among 11 cases(45%) were cured completely, but 6 cases(55%) were reoccurred, Timing of recurrences were distributed from 2-3 days till 4 months, and mean was 40 days. Patients assessed the satisfactions of therapy as excellent 2, good 1, fair 1, poor 7. complications were mild pain, hardening, and pigmentary change. Conclusion : 5% sodium morrhuate sclerotherapy might be useful as a primary surgical approach in cases of mucous systs because of simplicity. It is expected that therapeutic effects of sclerotherapy would be improved by repeated applications, changing to more potent sclerosants and meticulous pressure method.

經營컨설팅 서비스 品質 構成要因에 관한 硏究

김광훈,황규승 한국경영과학회 2001 經營 科學 Vol.18 No.1

This paper investigates the service quality determinants in management consulting. Quality dimensions in SERVQUAL research, as well as several dimensions specific to the consulting service, have been reviewed. A survey has been conducted by carefully developed questionnaires for the hypothesized eight quality dimensions. The results of the statistical analyses support the eight quality dimensions in the consulting service : reliability, assurance, responsiveness, empathy, ethics, participation, communication, and reputation. The results demonstrate that reliability, assurance, participation, and reputation are especially influential in determining customer satisfaction. The research results provide useful insights for a customer in assessing alternative service providers and foreseeing the outcome from the chosen consultants.

선천성 발진성 연모 낭종 1예

이나영,김지숙,최유원,황규광,함정희 대한피부과학회 2004 대한피부과학회지 Vol.42 No.3

An eruptive vellus hair cyst is an uncommon, benign, epithelial tumor with hair differentiation. Clinically, it presents as asymptomatic, flesh-colored to yellowish, follicular papules, 1 to 4 ㎜ in diameter, most commonly on the chest. It is usually sen in children and young adults but may be congenital. Histologically, it shows a middermal cyst lined by squamous epithelium containing keratinous material and vellus hairs. It has a tendency to clear spontaneously but may be persistent. We report a case of congenital eruptive vellus hair cyst in an 11-year-old girl who presented multiple pinhead-sized brown to black papules on her anterior chest since birth. (Korean J Dermatol 2004;42(3):362~363)

최근 5년간 피부외과술로 치료받은 환자의 분석 : 1994. 1∼1998. 12

신정현,강민정,조소연,황규광,함정희 梨花女子大學校 醫科大學 醫科學硏究所 2000 EMJ (Ewha medical journal) Vol.23 No.2

연구 목적 : 1990년대 이후 국외 및 국내에서 피부외과의 영역이 넓어지고 있으나 현재 국내에서 시행되고 있는 피부외과적 수술에 대한 통계는 아직 보고되지 않아 그 현황이 잘 파악되지 않고 있다. 이에 저자들은 본교실 미용피부외과 클리닉에 내원하여 수술을 받은 환자 1,075명을 대상으로 통계적 분석을 시행하여 피부외과 환자의 분포, 경향을 파악하여 향후 발전의 토대로 삼고자 한다. 방법: 1994년 1월부터 1998년 12월까지 5년간 이화여자대학교 의과대학 부속 동대문병원 피부과 미용피부외과 클리닉에 내원하여 수술을 받은 환자 1,075명을 대상으로 성별, 연령별, 주거지역별 분포와 진단명 및 수술의 종류에 대하여 통계적 분석하였다. 결과: 1) 남녀비는 1 : 2.4였고, 연령은 10개월부터 87세까지로 다양하였으나 20, 30대가 66.0%로 가장 많고 평균연령은 남자 30.6세, 여자 30.2세였다. 환자의 주거지역별 분포는 서울시가 75%로 가장 많았고 서울시내 지역구별의 차이는 크지 않았다. 2) 환자 1명이 두 가지 이상의 질환을 가질 때 각 질환을 개개로 간주하여 총 1.354예의 질환을 수술하였으며 반흔(39.8%), 색소성 질환(30.8%), 악성/양성종양(21.2%), 기타질환(8.2%) 순이었다. 3) 수술은 총 2,334회 시행되었고 그 종류별 빈도는 화학박피수술 가장 많아 846예(36.2%)이었고 다음으로 냉동외과술 650예(27.8%), CO_2 레이저 255예(10.9%), 기계박피술 209예(8.9%), 외과적 절제술 113예(4.8%), Mohs 미세도식수술 61예(2.6%), 혈관응고술 50예(2.1%), 피판재건술 48예(2.0%)이었으며 그 외 모발이식 15예, 표피이식 13예, 자가지방이식 2예 등이 있었다. 4) 각 반흔의 종류에 따라 분류하면, 여드름반흔은 화학박피술(72.7%), CO_2 레이저(11.9%) 및 기계박피술(9.7%)로, 위축성반흔은 기계박피술(37.3%). CO_2 레이저(27.8%) 및 펀치상향술(11.9%)로, 비후성반흔은 냉동외과술(28.2%), 기계박피술(24.2%) 및 CO_2 레이저(22.7%)로 치료하였다. 5) 악성종양 및 일부 양성종양에 Mohs 미세도식수술을 시행하였으며 재건술로 총 61예 중 피판재건술을 시행한 예가 가장 많아 45.9%이었고, 단순봉합이 36.1%, 복합봉합은 18.0% 이었다. 결론: 피부외과적 수술환자는 여자가 남자보다 2.4배 많았으나 남자의 비율이 증가추세에 있고 남녀 모두 평균 연령은 30대였다. 수술질환은 반흔과 색소성 질환이 가장 많아 미용적인 관심이 매우 높음을 알 수 있었고 연도별 유의한 차이는 없었다 총 2,334회 수술 중 화학박피술, 냉동외과술이 50% 이상을 차지하였고 반흔의 종류에 따라 선호되는 수술이 달랐다. 악성종양은 모두 Mohs 미세도식 수술하였으며 주로 국소 피판술로 재건하였다. 이상의 분석으로 피부외과적 수술환자의 분포, 대상질환, 수술방법 등을 빈도별로 파악할 수 있었으며, 향후 각 질환별 혹은 수술별로 세분하여 수술성과 및 만족도 조사를 시행함으로써 피부외과 분야 및 본 크리닉의 발전 방향을 설정하는 가늠자 역할을 할 것으로 기대한다. Background : The field of dermatologic surgery has seen trementdous developments in the past few years. Objective : Our purpose was to discuss current statistical data on the dermatologic patients treated by surgical methods at our institute. Methods : We analyzed 2,334 cases of surgeries performed on 1,075 patients at the Department of Dermatology of Ewha Womans University Tongdaemun Hospital during a period of 5 years (1994. 1 - 1998. 12). Results & Conclusion : The results are summarized as folows: 1) Of the 2,334 cases of surgeries, 846 cases(36.2%) were chemical peelings, 650 cases(27.8%) cryosurgeries, 255 cases(10.9%) CO_2, lasers, 209 cases(8.9%) dermabrasions, 113 cases(4.8%) scalpel surgeries, 61 cases(2.6%) Mohs micrographic surgeries, 50 cases(21.1%) sclerotherapy, 48 cases(2.0%) flap repair surgeries, 35 cases(1.5%) punch elevations, 15 cases(0.6%) hair transplantations, 13 cases(0.5%) epidermal grafts, and 2 cases(0.1%) autologous fat/collagen transplantations. 2) The ratio of male to female was 1 : 2.4 and the mean age of patients was 30.3 years. 3) A total of 1,354 cases of diseases were managed surgically : among them, the most frequent disease was scar(39.8%), followed by pigmentary disorders(30.8%), and benign or malignant tumors(21.2%). 4) With respect to the types of scars, acne scar was treated most frequently by chemical peeling (72.7% of 580 cases), atrophic scar by dermabrasion(37.3% of 126 cases), and hypertrophic scar (including burn scars) by cryosurgery(35.3% of 85 cases).

약진의 임상적 고찰

김지현,김문정,조소연,황규광,함정희 梨花女子大學校 醫科大學 醫科學硏究所 1999 EMJ (Ewha medical journal) Vol.22 No.4

연구목적 : 본 연구는 입원환자 및 외래환자를 대상으로 약진의 임상양상 및 의심되는 유발 약물에 대해 알아보고자 하였다. 방법 : 1994년 1월부터 1999년 5월까지 본원 피부과 외래환자와 본과에 피부병변으로 의뢰되었던 타과 입원환자 중 약진으로 진단되었던 131명을 대상으로 하였다. 약진으로 진단된 131명을 대상으로 현병력 및 과거력을 검토하였고, 문진, 이학적 검사소견, 일반 혈액검사, 간기능검사 및 IgE PRIST를 실시하였으며, 약진의 임상형태, 원인약제, 잠복기에 대해 조사를 하였다. 결과 : 1) 본 연구에서는 남녀간의 유의한 차이는 보이지 않았고. 연령분포는 20대와 30대에서 높은 빈도를 보였다. 2) 투약으로부터 약진발생까지의 시간, 즉 잠복기는 24시간에서 3일까지의 경우가 48예(36.6%)로 가장 많았고, 4일에서 6일까지 35예(26.7%), 7일에서 13일까지 25예(19.1%). 14일에서 20일까지, 21일에서 27일까지 6예로 나타났고. 28일 이상이 9예로 나타났다. 3) 약진환자의 임상형태는 발진형 발진이 가장 많았으며 그다음은 고정약진, 여드름양 발진, 급성 담마진, 자반, 수포성 발진, 태선양 발진, Stevens-Johnson 증후군, 그리고 AGEP 순으로 나타났다. 4) 약진환자 중 그 원인약제를 살펴보면, 항생제를 포함한 항균제가 22예로 가장 많았고, 다음은 해열진통제, 종합 감기약. 중추신경억제제, 항결핵제 순이었다. 5) 검사실 소견에서는 백혈구 증다증이 22.5%, 백혈구 감소증이 5.6%, 호산구 증다증이 14.5%, 비정상적인 SGOT/SGPT가 11.4%, 비정상적인 IgE수치는 8.3%였다. 결론 : 본 연구에서는 입원환자 및 외래환자를 대상으로 약진의 임상양상 및 의심되는 유발 약물에 대해 알아보고자 하였으며, 이전의 연구와 비교해 볼 때 연령 분포, 약진의 임상형태, 잠복기, 원인약제의 순서는 유사하거나 일치함을 확인할 수 있었다. 또한, 우리나라는 의사의 처방없이 약물을 남용, 오용하는 경향이 크고, 여러 가지 약물을 동시에 투여하는 경우도 많으며, 구성성분을 알 수 없는 한약제의 사용이 빈번하므로 약물을 처방하는데 있어서 이에 대한 고려가 필요한 것으로 생각된다. Objectives and Method : This study attempts to evaluate the clinical manifestations and causative drugs of drug eruptions at Ewha Womans University Tongdaemun Hospital by retrospective study of outpatients, inpatients and consulted patients(number : 121, duration : 1994. 1 - 1999. 5). Results : 1) Most drug eruptions occurred in patients at the age of 20 - 39 years old. 2) The cutaneous manifestations of drug eruptions in the order of frequency were as follows : exanthematous eruption, fixed drug eruption, acneiform eruption, purpura, urticaria, bullous eruption, lichenoid eruption, Stevens-Johnson syndrome, and acute generalized exanthemic pustulosis. 3) Drug eruption developed most frequently from 24 hours to 3 days of drug intake. 4) Most common causative drugs were antibiotics, followed by antipyretics and analgesics. 5) Laboratory abnormalities were leukocytosis(22.5%), eosinophilia(14.5%), abnormal AST/ALT(11.4%), abnormal IgE titer(8.3%), and leukopenia(5.6%). Conclusion : The most frequent clinical feature of the drug eruption were exanthematous in nature and the most common causative drugs were antibiotics, as suspected. Since too many patients take various unidentified drugs at drug stores in Korea, physicians need to exercise special care in prescribing drugs and evaluating patients with drug eruption.

윤상 다륜형 아급성 피부 홍반성 루푸스 1예

강민정,박혜진,조소연,이미애,황규광,함정희 대한피부과학회 1999 대한피부과학회지 Vol.37 No.6

We report an annular type of subacute cutaneous lupus erythematosus(SCLE) which is rare in Korea, A 23-year-old female had erythematous annular rashes with a mild itching sensation on the face, trunk and both extremities. She also had painless oral mucosal ulceration, diffuse hair loss and mild arthralgia. Serologic abnormalities of the patient were positive anti-Ro Ab, ANA and Anti-ds-DNA Ab. The histopathologic findings showed vacuolar degenerations in the basal cell layer, mononuclear cell infiltrate in the upper dermis, and dermal edema. Direct IF revealed granular deposition of IgG and IgA at the dermo-epidennal junction.

결절성 황색종과 동반된 제 Ⅲ 형 과지질단백혈증 1예

김지현,김연진,김현주,조소연,황규광,함정희 梨花女子大學校 醫科大學 醫科學硏究所 2000 EMJ (Ewha medical journal) Vol.23 No.1

We report a case of type Ⅲ hyperlipoproteinemia associated with tuberous xanthoma, which is improved by treatment with lovastatin and bezafibrate. A 34-year-old female patient visited our clinic for evaluation of multiple yellowish-brown papulonodules on the kness, elbows and palms. Serum lipid examination showed an abnormal elevation of serum cholesterol and triglyceride. Lipoprotein electrophoresis showed a single peak at pre-β and β portion without separation. The biopsh specimen from a nodule on the knee and a papule on the palm revealed characteristic findings of xanthoma. We diagnosed the case as type Ⅲ hyperlipoprotei-nemia. After 3 months of treatment with diet restriction, lovastatin and bezafibrate, the serum levels of cholesterol and triglyceride were reduced to normal level. The skin lesion of the palm showed complete regression and ones on both knees and elbows were moderate improvement.

전신성 홍반성 낭창의 임상적 고찰

신영태,김종학,장윤경,양종오,구영선,강민규,황평주,나기량,이강욱,서광선 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The epidemiology, diagnostic criteria, clinical features, symptoms and signs laboratory findings, kidney pathology, and clinicopathologic correlation of systemic lupus erythematosus(SLE) were analyzed. The 63 patients studied were managed at the Department of Internal medicine, CNUH, from January 1983 to December 1997. Kidney biopsy was performed in 53 patients out of 63 patients with SLE. The results were as follows: 1. The ratio of male to female was 1:26. They were 12 to 71 years old and mean age was 32.1 years old. The peak age incidence was 4th decades(30%). 2. The most frequent chief complaint on admission was generalized edema. Most patients complain two or more symptoms. 3. Immunologic and renal disorders were the most frequently observed in the ARA criteria of SLE. And the positive ANA, hematologic disorder, malar rash, and arthritis, were observed in order of frequency. 4. Among the 53 patients with renal biopsy, 30 patients revealed class Ⅳ lupus nephritis(56%), class II in 12 patients(23%), class V in 8 patients(15%) and class III in 2 patients(6%). 5. The cases of lupus nephritis represented as nephrotic syndrome were high in the class IV with 68% and class V with 86%. 6. Of 30 patients who can be followed up, 5 patients resulted in death(17 % of mortality). They "were 14 to 57 years old and mean age was 28 years old. Follow up duration were from 1 month to 6 years and 3 months, and mean duration was 1 year and 1 month, but 3 cases 7. The causes of death were as follows: Two cases were due to seizure and coma resulted from CNS involvement. One was sepsis due to miliary the & pneumonia. One was dilated cardiomyopathy and heart failure due to cardiac ac involvement. And the other one was sepsis and acute renal failure resulted from cellulitis. 8. Prednisolone was used in all patients basically, and methyl-prednisolone pulse therapy, antimalarials and alkylating agents were used in some cases. In the cases of combined therapy, the activity of SLE was well controlled.

Study of combined treatment of ultrapulse CO₂ laser partial excision and multiplex laser for hemangioma and nevus flammeus

( Kyu Kwang Whang ),( Eun Sun Choi ),( Rosa Kim ),( Ji Yeon Byun ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Since all superficial, interconnecting and deep vessels of nevus flammeus, hemangioma and AV malformation proliferate at the dermis and the subcutaneous fat layer, treatment by laser only is demanding, especially for adult patients. To treat hemangiomas located on lips is challenging because of blood pumping during surgery and of difficulty in shaping of lips. Objectives: To treat recalcitrant hemangioma, nevus flammeus and AV malformation for adults more effectively. Methods: 97 cases (male 32, female 65) of nevus flammeus, hemangioma and AV malformation (mostly on the lip) for 10 years are included and investigated. Aforementioned cases were treated using CO₂ laser partial excision with subdermal dissection, coagulation and/or removal of primary, deep vessels by radiofrequency, and pulsed dye laser with long pulse Nd:YAG (Cynergy multiplex), which could penetrate deeper level than 595nm only. Results: These cases of recalcitrant hemangiomas were treated effectively, preserving anatomical shape as much as possible, with the combination treatment concept. Conclusion: By combining CO₂ laser surgery and multiplex laser, hemangiomas and nevus flammeus, that had been known to be difficult to treat, were removed successfully.